Purpose: To investigate the correlation between performance on a virtual reality simulator and real-life cataract surgical performance. Setting: Nine ophthalmology departments in Denmark and Copenhagen Academy for Medical Education and Simulation, Copenhagen, Denmark. Design: Prospective multicenter study. Methods: Cataract surgeons with different experience levels were included. The participants performed 3 consecutive video-recorded phacoemulsification surgeries that were rated by masked raters using the Objective Structured Assessment of Cataract Surgical Skills (OSACSS) scoring system. Thereafter, the participants performed a previously validated test on an Eyesi virtual reality simulator. Primary outcomes were the mean OSACSS score from all 3 surgeries and the simulator score from the participants' first repetition of the performance test. Result: Nineteen surgeons participated. There was a statistically significant correlation between the simulator performance score and the mean OSACSS score across all experience levels, with a Pearson correlation of 0.65 (P =.003, R² = 0.42). Conclusion: Simulator performance was significantly correlated with real-life cataract surgical performance.