Background The Tetra Flex accommodating intraocular lens (IOL) was designed to supply the patients both satisfied far and near vision after cataract surgery. So we need to evaluate the safety, distance and near visual acuity, subjective accommodation and IOL mobility with the Tetra Flex accommodating IOL implantation. Methods Fifty eyes of 42 study-eligible cataract patients, who gave informed consent at a single eye clinic in China over a 10-month period, underwent phacoemulsification with Tetra Flex IOL implantation. At three months postoperation, uncorrected visual acuities (UCVA), best corrected visual acuities (BCVA), distance-corrected near visual acuities (DCNVA), subjective accommodation using the defocus method, and pilocarpine-induced IOL mobility were measured Results No postoperative complications were noted in the study Three months postoperation UCVA and BCVA were 20/40 or bettter in 82% (41/50) and 92% (46/50) of eyes, respectively; 66% (33/50) of the eyes had DCNVA of Jager (J) 4 or better at 3 months. In addition, the mean subjective accommodation was (0.94 +/- 0.61) diopters (D) (range from 0 50 to 1.50 D) and pilocarpine-induced IOL mobility was (337 +/- 124) mu m (range from 121 to 501 mu m) with the Tetra Flex. High relationship (r(2)=0 901, P <0.01) was found between these two measurements. Conclusion Implantation of the TetraFlex is safe and leads to excellent uncorrected distance vision and good uncorrected near vision.