OBJECTIVE: (1) To present a new, inexpensive technique for manual cataract extraction using a new irrigation-aspiration cannula (Beirouty) and to report the results of this technique. (2) To compare the results of this technique with phacoemulsification and other techniques of smallincision surgery. STUDY DESIGN: A prospective analysis of patients who had cataract extraction by the manual nucleosuction technique (MNT) since December, 1992, performed by 1 surgeon (Z.A.YB.). SETTING: General Ophthalmic Unit, Stobhill NHS Trust, Glasgow, U.K. PATIENTS: Forty-nine patients (63 eyes), aged 11–85 years, with suitable cataracts. MAIN OUTCOME MEASURES: To determine perioperative complications, best corrected Suellen visual acuity, astigmatic shift, induced astigmatism and time to final refraction. RESULTS: There were no cases of posterior capsular tears and / or vitreous loss. Best corrected visual acuity was 6/9 or better in 85% of eyes. Astigmatic shift was negligible. Surgical re-intervention was required in 1 eye for slight wound dehiscence. All patients received their spectacles at 6–8 weeks. CONCLUSIONS: MNT is a safe and easy technique to learn. The results are very favourable when compared to other techniques of cataract surgery through a small incision. This procedure is performed with standard cataract instruments.