This is a retrospective study of 53 children who had immediate sequential bilateral cataract surgery (ISBCS) (37/53) or delayed sequential bilateral cataract surgery (DSBCS) (16/53) at a tertiary referral paediatric hospital in Toronto, Canada. Clear visual axis was the measure of effectiveness. The time frame of eight weeks postoperatively was utilised. Both direct and indirect costs were calculated. It was found that ISBCS had a cost-saving of CAD 3776 from a societal perspective and 2200 from the healthcare system perspective, per patient, with a total of 5975. Both types of surgery were equally effective, but ISBCS was less costly than DSBCS from both perspectives.