Background: Among the various modern cataract surgery techniques, phacoemulsification with foldable intraocular lens (IOL) implantation is most commonly performed. Foldable IOLs, owing to their smaller incisions potentially reduce Surgically induced astigmatism (SIA). Conversely, non-foldable IOLs might offer advantages such as affordability, particularly benefiting economically challenged individuals. Aim: To compare the visual outcomes and SIA after phacoemulsification with foldable versus non foldable IOL. Method: In a prospective, comparative, randomized clinical trial of phacoemulsification cataract surgery, 58 patients received hydrophilic foldable IOL through 2.8mm clear corneal incision and 58 patients received non foldable Polymethyl Methacrylate (PMMA) IOL through 6mm sclerocorneal tunnel. Preoperative and postoperative visual acuity at day 1, 1 month, and 3 month and SIA at 1 month, and 3 month follow up visits were analysed. Results: The post-operative UCVA at day 1 was 6/18 or better in 69.2% in group A and 76.0% in group B (p = 0.294). Post-operative BCVA at 4 weeks was 6/6-6/9 in 73.1% patients in group A and 84.0% patients in group B. The mean SIA at week 4 in group A was1.10D (0.51SD) and 0.71D (0.32SD) in group B (p< 0.001). Conclusion: Phacoemulsification with the implantation of a foldable IOL through a 2.8mm clear corneal incision results in less post-operative astigmatism compared to phacoemulsification with the implantation of a non-foldable IOL through a 6mm sclerocorneal tunnel. Thus phacoemulsification, whether paired with a foldable or rigid PMMA IOL, delivers excellent results when performed by experienced cataract surgeons.