AIM: To evaluate blood pressure (BP) changes during phacoemulsification (PC) and femtosecond laser (FSL)-assisted cataract surgery. METHODS: A retrospective chart review was performed for all patients who received traditional phacoemulsification surgery (PC group) and FSL-assisted cataract surgery (FS group) from July 2013 to December 2014. Totally 206 eyes from 133 patients receiving the two types of procedures were included. Patient characteristics (age, gender, and hypertension history), pre- and post-operative BPs were collected. RESULTS: The pro-operative systolic and diastolic BPs (mm Hg) were 124.89±20.48 vs 126.98±16.85, and 71.88±9.81 vs 73.56±10.03, in PC and FS groups, respectively. While the post-operative systolic and diastolic BPs (mm Hg) were 130.13±22.59 vs 134.77±17.52, and 73.41±11.62 vs 78.89±12.2, in PC and FS groups, respectively. Paired-sample t-tests showed obvious systolic and diastolic BP elevations in FS group after surgery (P=0.001 and 0.007) and no reliability in PC group (P=0.094 and 0.359). A linear regression model revealed systolic and diastolic BP elevations, which were related to longer surgical times for FS group (P=0.008 and 0.021). Age, gender, and hypertension history were not correlated with blood pressure elevation in either group. CONCLUSION: BP increases but at a limited level after FSL-assisted cataract surgery compared to traditional phacoemulsificationKEYWORDS: cataract surgery; blood pressure; femtosecond-assisted cataract surgery; phacoemulsification