Increased anxiety has been shown to be associated with greater pain in a number of procedures. In this observational, non-interventional study, the authors sought to evaluate the correlation between pain with phacoemulsification surgery (under topical and intracameral local anaesthesia) and the patient’s anxiety level prior to surgery. Visual analogue scale for anxiety (VASA) was used to record the level of anxiety (ranging from zero or ‘no anxiety’ to 10 or ‘unbearable anxiety or fear’). The visual analogue scale for pain (VAS) was used to assess pain. The study showed a significant correlation between VAS and VASA and also between pain (VAS) and duration of surgery. Patients with severe anxiety (VASA ≥7) were more likely to experience severe pain (VAS ≥7). Furthermore, an anxiety score of more than four demonstrated a sensitivity of 88.9% and specificity of 69.4% in predicting severe pain. This study is important because finding methods to alleviate pain during surgery is of paramount importance and this would involve, amongst other things, identifying methods for reducing anxiety prior and during surgery. The authors acknowledge that the results of this study do not imply that reducing anxiety will necessarily lead to a reduction in pain.