Congenital cataract is one of the main causes of children's blindness worldwide. The success of treatment depends on the time of diagnosis. Lack of visual stimuli during a sensitive period of child growth results in the disruption of the neurobiological development of visual pathways in the brain. Pediatric vision screening, early diagnosis and prompt ophthalmic surgery are essential factors in preventing development of irreversible amblyopia. Detailed examination consisting of detailed history, determination of morphological type of congenital cataract and potential accompanying abnormalities are crucial in finding out the ideal timing and planning the surgical intervention. Thorough assessment of the child's health condition is helpful in identification of possible systemic diseases, including metabolic conditions or genetic syndromes. Child’s eyes have some specific features which distinguish them from adult's eyes. Pupil is narrower, lens is smaller, outer layer of the eye and lens capsule are more elastic, which makes them more complex to manage. Lens substance retains a soft consistency and removal is usually performed by irrigation and aspiration. The development of custom surgical instruments and advances in surgical techniques have enabled surgery at a very early age with better visual prognosis. Myopic shift, caused by increase in the axial length of the eye and decrease of refractive power of the cornea, remains one of the mayor challenges in congenital cataract surgery. Posterior capsule opacification, secondary glaucoma, and intraocular lens malposition are still the most prevalent complications requiring lifelong postoperative follow-up in children subjected to congenital cataract surgery.