Modern cataract surgery represents an amalgam of new technologists which may include phacoemulsification, foldable intraocular lenses and, in many instances, clear corneal incision. The fusion of newer techniques has allowed for a re-evaluation of the anesthetic needs for cataract surgery. These minimally incisive surgical procedures have allowed us to reintroduce a very old technique: topical anesthesia into cataract surgery. This article reviews the present day techniques that are available from the use of general anesthesia to the use of injection technique as well as topical.