In this cross-sectional review of the European Registry of Quality Outcomes for Cataract and Refractive Surgery (EUREQUO) including 2,853,376 patients and 31,749 cases with posterior capsular rupture (PCR), the authors observed a trend of reduction in PCR rate from 1.44% in 2008 to 0.60% in 2018 (range: 1.65% to 0.60%). Risk factors identified included age, hyperopic target refraction, corneal opacities, diabetic retinopathy, the use of trypan blue, mechanical dilation of the pupil, and glaucoma. Age as a risk factor had an adjusted odds ratio (OR) of 1.007 and although the OR increased 0.007 for each additional year of age, this means an 80-year-old has a 20% higher chance of PCR compared with a 55-year-old patient. Higher PCR incidence in males could be secondary to a higher incidence of intraoperative floppy-iris syndrome (IFIS). Corneal opacities and diabetic retinopathy were associated with the highest ORs of 3.21and 2.74 respectively. A previous vitrectomy did not entail a higher risk of PCR in this analysis. Limitations of the study include the lack of data on previous intravitreal therapy and medication-induced IFIS, and that data are self-reported with an inherent risk of under-reporting.