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Background: In India, manual small incision cataract surgery is popular and probably the most performed surgery in community based high volume surgical campaigns. Modern cataract surgery either by phacoemulsification or manual small incision cataract surgery (MSICS), both require good pupillary dilatation. The present study has evaluated the efficacy, sustainability and safety of intracameral mydriasis in performing manual small incision cataract surgery under peribulbar anaesthesia in comparison to traditional tropical eye drops as there are very limited studies. Methods: A single blind randomized controlled trial was conducted among patient attending ophthalmology OPD. Detailed history of the patient with complete ocular examination with slit lamp and fundus of patient was viewed with direct and indirect ophthalmoscope, and slit lamp bio microscopy with 90 D lens. Patient were randomly subdivided into two groups, that is, topical and intracameral group. Results: A total of 34 study subjects were enrolled in both the study groups with majority of the participants in both the study group were in the age group of 51 to 60 years followed more than 60 years of age and least number of patients in the age group of 41 to 60 years. Gender-wise distribution of study groups was also comparable. The mean duration of surgery among patients in topical mydriatic group was relatively higher when compared to intracameral mydriatics group. There was statistically no significant difference in the pupil size between the two groups. Conclusion: There was no significant difference in pupil dilation between the topical and intracameral mydriatics with no significant difference in the uncorrected, best corrected, and LogMAR visual acuity. [ABSTRACT FROM AUTHOR]