Background Endophthalmitis is a serious complication after cataract surgery. Patients and Methods Therefore. a retrospective study was performed by reviewing patient-records of all cases of endophthalmitis after catract surgery that were treated at the department of ophthalmology of the University Hospital in Mainz between January 1986 and December 1995. Results 44 eyes were treated for endophthalmitis. Of those, 38 had been referred. In 15 eyes cataract surgery was performed on an outpatient basis. In 20 cases the onset of endophthalmitis occurred within the first postoperative week. We isolated staphylococcus epidermidis (14), staphylococcus aureus (4), other gram-positve microorganisms (15). gram negative bacteria (2) and candida (1). As risk factors we found a wound dehiscence (14), an intraoperative loss of vitreous (11), diabetes (11), skin-diseases like rosacea or neurodermatitis (6). In 36 cases a vitrectomy was performed. After a mean follow-up of 25 +/- 22 months 26 patients had a visual acuity of 0,05 or better. Conclusion Gram-positive bacteria showed Co be the most common causetive microorganisms. In a third of all cases the sample demonstrated no growth. More than 80% of the eyes were treated by vitrectomy. About 60% of the patients obtained a visual acuity of 0,05 or better.