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Objective: The aim of this study was to evaluate the safety of simultaneous bilateral congenital cataract surgery in children in terms of developing postoperative endophthalmitis. It was an observational case study in department of ophthalmology, Unit-1, Dow Medical College, Dow University of Health Sciences, Dr. Ruth KM Pfau Civil Hospital Karachi. From February 1st, 2019 to January 31st, 2020. Patients and Methods: This study was conducted after the approval of Institutional Review Board of Dow University of Health Sciences, on 60 eyes of 30 children below the age of 12 months, who have been operated for bilateral congenital cataract in a single session by a single surgeon dealing in pediatric cases. Patients with bilateral congenital cataracts under the age of 12 months were included. While, patients with corneal abnormalities or haziness, high intraocular pressure or history of any ocular injury and birth trauma were excluded. Ocular examination was performed and investigations like B scan ultrasonography, TORCH profile, investigations for systemic association and general anesthesia fitness were done. All the cases were operated under general anesthesia with aseptic technique for each eye separately. Postoperatively the children were examined on the next day, first week, second week, fourth week and eighth week. On successive visits, signs of inflammation, clarity of visual axis and intraocular pressure were monitored. Results: The study was conducted on 60 eyes of 30 patients. The mean age was 7.5± 3.74 months. There were 16 males (53.3%) and 14 females (46.7%). 10 eyes of 10 patients (16.66%) showed moderate to severe inflammation in first week follow-up, 2 out of 60 eyes (3.33%) did not get improvement and developed postoperative complications i.e. unilateral inflammatory pupillary membrane and unilateral decentered pupil. 58 out of 60 eyes (96.67%) did not develop any complications post-operatively, while not a single patient showed any complication regarding general anesthesia. Conclusion: Simultaneous bilateral congenital cataract surgery was found to be safe for the children with negligible chance of developing endophthalmitis by maintaining proper aseptic measures. [ABSTRACT FROM AUTHOR]