The study investigated the prevalence and clinical significance of corneal astigmatism in 600 eyes from 306 cataract patients aged over 40 years in southern Italy. The average age of the patients was 72.5 ± 8.5 years. The measured values were the axial length of the eye 23.5 ± 1.6 mm, the depth of the anterior chamber 3.1 ± 0.5 mm and the keratometric power 43.9 ± 1.5 D. The mean corneal astigmatism was 1.02 ± 0.76 D, with 39.8% of eyes having astigmatism ≥ 1.0 D and 9.3% ≥ 2.0 D. > 26 mm made up 7.1% of the sample. The findings emphasize the need for accurate preoperative characterization of astigmatism for surgery planning and toric IOL selection. These data support the routine consideration of toric IOLs to optimize refractive outcomes after cataract surgery.