Background: Posterior capsular opacification (PCO) is the most common delayed complication of cataract surgery with IOL implantation. The incidence of (pco) was reported to be 20.7% at two years and 28.7% at five years after cataract surgery. The purpose of our work is to evaluate the corneal endothelium after Nd:YAG laser capsuolotomy by specular microscope. Patients and Methods: The study included 60 patients, age ranging from 18 to 65 years. This is a descriptive longitudinal study. This study conducted in “Memorial institute of ophthalmic research in Giza". Results: Nd:YAG laser used to perform posterior capsulotomies on patients that had undergone extracapsular cataract extraction. Only 7 (11.7%) patients had visual acuity improved to 0.3 less improvement in visual acuity. Vision was improved in all patients at least by one line. Visual outcome was not affected by complication. We did not document rise of IOP in any of our patient IOP after operation. Conclusion: Diminution of vision 2-3 years after successful cataract surgery became the chief complaint this is due to posterior capsule opicification, several advances and research has been done to prevent PCO by improving the surgical techniques, better IOL materials and design, use of therapeutic drugs but Nd:YAG laser capsulotomy is considered safe and with a low risk of complication.