Background: The development of binocular diplopia after cataract surgery is a serious complication. The present retrospective study aims to improve our understanding of this phenomenon and its prevention. Patients and Methods: A series of 11 patients with binocular diplopia after cataract surgery under local retrobulbar anaesthesia is presented. The patients were followed over a period ranging from 1 to 31 months. Results: Three types of disorders were found: muscular or nervous injuries (7/11), decompensated latent heterophorias (2/11), and disclosed previous strabismus with abnormal retinal correspondence (2/11). The treatment was surgical for 3 patients, and a prismatic correction was prescribed for 6 patients. Spontaneous recovery was seen in 5 patients. Conclusion: Fortunately, binocular diplopia after cataract surgery is a rare complication, with multiple aetiopathologies. Muscular injuries, related to the anaesthesic technique, are the most frequent disorders responsible for diplopia and often require strabismus surgery.