Abstract Background: Cataract is the leading cause of blindness worldwide, increasing with age. Cataract development is influenced by modifiable and non-modifiable risk factors. Objective: To analyze the determinants of cataract in Makassar City. Method: This study used a case-control design and was conducted at Primaya Hertasning Hospital, Kemenkes RI Eye Hospital, Hajj Hospital and Pelamonia TK II Hospital, Makassar city. The number of samples was 393 case samples and 393 control samples. Results: There was an association between risk factors such as high-risk age group (p=0.000), male gender (p=0.000), history of trauma (p=0.000), diabetes mellitus (p=0.000), hypertension (p= 0.000) and intraocular disease (p=0.000). A history of hypertension had a 32.700-fold risk of developing cataract [OR 32.700 (95% CI: 15.782 - 67.755)], followed by a history of DM [OR 24.405 (95% CI: 12.215 - 48.762)], high risk age [OR 16.373 (95% CI: 10.562-25.383)]. A history of trauma has an Exp (B) value of 51.237 which means that a history of trauma has a 51 times chance of experiencing cataracts. Conclusion: High-risk age, male gender, history of trauma, diabetes mellitus, hypertension, and intaocular disease are determinants of cataract incidence in Makassar City. History of trauma is the most influential variable. Abstrak Latar Belakang: Katarak merupakan penyebab utama kebutaan di seluruh dunia, meningkat seiring bertambahnya usia. Perkembangan katarak dipengaruhi oleh faktor risiko yang dapat dimodifikasi dan tidak dapat dimodifikasi. Tujuan: Untuk menganalisis determinan kejadian katarak di Kota Makassar. Metode: Penelitian ini menggunakan desain kasus-kontrol dan dilakukan di Rumah Sakit Primaya Hertasning, RS Mata Kemenkes RI Makassar, RSUD Haji dan RS TK II Pelamonia. Jumlah sampel adalah 393 sampel kasus dan 393 sampel kontrol. Hasil: Terdapat hubungan antara faktor risiko seperti kelompok usia berisiko tinggi (p=0,000), jenis kelamin laki-laki (p =0,000), riwayat trauma (p =0,000), diabetes melitus (p=0,000), hipertensi (p=0,001) dan penyakit intraokular (p=0,001). Riwayat hipertensi memiliki risiko 32,700 kali lipat untuk mengalami katarak [OR 32,700 (95% CI: 15,782 – 67,755)], diikuti oleh riwayat DM [OR 24,405 (95% CI: 12,215 – 48,762)], usia risiko tinggi [OR 16,373 (95% CI: 10,562-25,383)]. Riwayat trauma mempunyai nilai Exp (B) 51,237 yang berarti riwayat trauma mempunyai peluang 51 kali mengalami katarak. Kesimpulan: Usia risiko tinggi, jenis kelamin laki-laki, riwayat trauma, diabetes melitus, hipertensi, dan penyakit intaokular merupakan determinan kejadian katarak di Kota Makassar. Riwayat trauma merupakan variabel yang paling berpengaruh.