Purpose <p>To analyze the refractive outcomes in patients with different degrees of astigmatism undergoing cataract surgery with toric monofocal IOL implantation.</p> Methods <p>A consecutive series of patients that underwent cataract surgery and Toric IOL implantation was reviewed. The preoperative evaluation of anterior and posterior keratometry, corneal topo/tomography was performed with AS-OCT Casia 2. Basing on real cylinder, the patients were divided in three groups. Group 1: total corneal astigmatism ≤ 1D, group 2: total corneal astigmatism between 1 and 1.5 D, group 3: total corneal astigmatism ≥ 1.5D. The residual post-operative refractive astigmatism and the percentage of astigmatic correction were evaluated one months after the surgery. Vector astigmatism analysis was performed applying the Alpins method.</p> Results <p>100 eyes of 100 patients were enrolled. The mean post-operative refractive astigmatism (in absolute values) was 0.23 ± 0.28 D; 0.16 ± 0.27 D and 0.48 ± 0.44 D in group 1, 2 and 3 respectively. The best percentage of astigmatic correction was found in group 2 (88.05 ± 20.11%) with a significant difference with group 1 and 3. The average AE was 5.68 ± 8.33° in group 1, 2.2 ± 4.13° in group 2 and 3.97 ± 4.89° in group 3. The differences were significant in particularly between the second and the third group and less between the first and the second group. The best DV and IOS were found in group 2.</p> Conclusion <p>Toric IOL was successfully applied in any amount of astigmatism and that the best refractive results were achieved in mild astigmatism.</p>