Purpose: To assess prospectively the visual outcomes of multifocal and monofocal intraocular lens (IOL) implantation in selected patients with a minimum follow-up of 18 months. Setting: Department of Ophthalmology, National Health Service (INSALUD), Puerta de Hierro University Clinic, Madrid, Spain. Methods: This prospective study comprised two groups of 50 eyes each: one with AMO Array multifocal IOLs and the other with monofocal IOLs. Main outcome measures were Snellen and Began 96% distance visual acuities; Jaeger and decimal near acuities; Regan contrast sensitivity test at 96, 50, 25, and 11%; brightness acuity test (BAT) on distance acuity at Regan 96%; depth of focus measured with the Began 96% distance test; defocusing from +3s to -4s; subjective evaluation of optical side effects. Results: The differences between groups in mean distance vision and BAT results were not statistically significant. Contrast sensitivity results at 96 and 50% were similar, but there were significant differences of 0.94 and 1.14 lines on the 25 and 11% charts, respectively (P <.01). Near vision without addition in the multifocal group was significantly better and depth of focus significantly wider than in the monofocal group (P <.001). Conclusion: With appropriate patient selection, the AMO Array IOL provided distance acuity and contrast sensitivity similar to that of the monofocal IOLs and excellent intermediate vision. Near vision, without spectacles, with the multifocal lens was functionally acceptable although short of refractive power for best acuity results.