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Purpose: To evaluate the visual and economic benefits of same-day bilateral cataract surgery versus separate-day bilateral cataract surgery in the United States., Setting: Private practice, Amarillo, Texas, USA., Design: Prospective controlled nonrandomized clinical trial., Methods: A cohort of patients having same-day bilateral cataract surgery was age-matched with a cohort of control patients who had standard separate-day bilateral cataract surgery. The primary outcome was a comparison of the direct cost for the patient, physician, ambulatory surgery center (ASC), and third-party payer., Results: The same-day cohort (42 patients, 84 eyes) had similar baseline characteristics and postoperative outcomes as the control cohort (42 patients, 84 eyes). The same-day cohort had less total distance traveled for care (P = .0039 and P < .0001 for in-town and out-of-town residents, respectively), less total time spent traveling for care (P = .0008 and P < .0001 for in-town and out-of-town residents, respectively), less total number of visits required for care (P < .0001), and less total time for vision recovery (P < .0001) than the control cohort. The physician and ASC reimbursements were lower in the same-day cohort (P = .0028 and P = .0016, respectively), whereas the total physician time spent caring for the patient in surgery was not different between the 2 groups (P = .7310). The total ASC expenses were higher in the same-day cohort (P < .0001). The total third-party payer cost was significantly less in the same-day cohort (P < .0001)., Conclusion: Visual and economic benefits for the patient can be achieved with same-day bilateral cataract surgery in the U.S. at the present time., Financial Disclosure: No author has a financial or proprietary interest in any material or method mentioned., (Copyright © 2015 ASCRS and ESCRS. Published by Elsevier Inc. All rights reserved.)