The study was performed on (50) eyes of (50) patients who attended the Ophthalmology Department at Al-Assad Hospital University in Lattakia, from Nov 2012 to Nov 2013. Our study included 32 (64%) males and 18 (36%) females who had senile cataract with mean age about (59.88±7.24 years). The aim was to study anterior corneal surface changes after phacoemulsification and the role of these changes in the refractive error after surgery. The patients were followed by regular periods during three months after surgery. In each visit, we recorded Best Correct Visual Acuity (BCVA), vertical, horizontal keratometry reading (K-reading) and sphere and astigmatic refraction errorby (Grand Seiko GRK-1 Auto Kerato-Refractometer) in a private data sheet for each patient. Results showed improving in BCVA from (0.27±0.1) before surgery to (0.92±0.16) three months after surgery. There was no significantstatistical value in steepening of horizontal meridian (0.12)D (P=0.13),but significant flattening in vertical meridian (0.21)D (P=0.0001), with no significant flattening in mean keratometric reading (0.05)D (P=0.215) three months after surgery. The mean of spherical refraction error after three months of surgery was (0.24±0.93)D. The refractive astigmatism after surgery was about (-1.08±0.74)D, and the keratometric astigmatism about (1.18±0.63)D, there was no significant difference between them(P=0.61).The Surgically Induced Astigmatism ( SIA) was about (0.47±0.38)D. There was no significant statistical value according to the keratometric astigmatism before and after surgery(P=0.785). So, we can say that the anterior corneal surface changes after phacoemulsification are responsible for (20.83%) of the spherical refractive error after surgery. The corneal astigmatism after surgery is interpreting the refractive astigmatism in about (76%) of patients and SIA is responsible for about (67%) of surgery induced refractive astigmatism.