Objective: To report age- and sex-specific incidence rates of cataract surgery in France and evaluate the trends of cataract surgery from 2009 to 2012. Design: Cohort study Subjects: Data for all patients who underwent primary cataract surgery in France between January 2009 and December 2012 were collected from the national database. Methods: Annual incidence rates were calculated and adjusted to the corresponding-year national population data from the French national institute of statistics. Kaplan-Meier analysis was used to assess the time between surgeries for both eyes and the relationship between age and interval for bilateral surgery. Main Outcome Measures: Age- and sex-specific incidence of cataract surgery. Results: Over the 4 years, 2,717,203 eyes in 1,817,865 patients (59.1% women, mean age 73.5±0.015 years) underwent cataract surgery. Between 2009 and 2012, the total number of operated eyes per year increased, from 634,070 to 723,172 (+14.0%) and the number of patients with one or both eyes undergoing cataract surgery decreased, from 475,301 to 449,318 (-5.5%). The incidence of cataract surgery increased from 9.86 to 11.08/1,000 person-years and that of operated patients (one or both eyes) decreased from 7.39 to 6.89/1,000 person-years. The incidence of cataract surgery ranged from 1.06/1,000 person-years for patients 40-49 years old to 65.94/1,000 person-years for those 80-89 years old. Between 2009 and 2012, the probability of second-eye surgery 12 months after the first-eye surgery increased from 40.6% to 51.2% (P<.0001). The median interval for surgery between eyes was 29 (interquartile range 14-86) days and decreased over the study period (P<.0001). The rate of posterior capsular tear was 0.20%, with a higher proportion from extracapsular extraction than phacoemulsification (7,9% vs 0.15%; P<.0001). The proportion of patients who underwent cataract surgery with a history of high myopia or eye trauma or retinal detachment was 0.49%, 0.21%, and 0.80% respectively. Conclusions: This study documented the incidence and trends in cataract surgery in the overall population in France. Between 2009 and 2012, the number of people undergoing cataract surgery slightly decreased, but the total number of operated eyes increased because the proportion of surgeries on the second eye increased.