Aims: Prior to establishing a national prevention of blindness program a population based survey was conducted in Cape Verde Islands in1998. The objectives of the survey were to estimate the overall and age-specific prevalence of blindness and low vision, to identify the main disorders causing blindness and low vision, and to estimate the population need for basic eye care services. Methods: A two-level cluster random sampling procedure was used, selecting 30 clusters from the nine inhabited islands and 3,803 persons of all ages were included in the sample. Results: 3,374 persons were examined (coverage 88.7%). The prevalence of bilateral blindness (visual acuity in the better eye less than 3/60) was 0.8% (95% confidence interval [CI] 0.5–1.1), of bilateral low vision (6/18 to 3/60 in the better eye) 1.7% (95% CI: 1.3–2.2) and of monocular blindness 1.5% (95% CI: 1.2–2.0). The major causes of blindness were age related cataract and glaucoma (57.7% and 15.4%, respectively, of blind people recruited). The major causes of bilateral low vision were cataract, refractive errors, and macular disorders (46.2%, 26.8%, and 8.9%, respectively, of persons with low vision). Nontrachomatous corneal opacities accounted for 7.7% of bilateral and for 11.5% of monocular blindness. Vascular retinopathy was responsible for 7.7% of bilateral and for 9.6% of monocular blindness. Trachoma is not a public health problem as only 2.3% of children less than 10 years of age were suffering from active trachoma. Palpebral or limbal vernal conjunctivitis were encountered in 4.5% of persons under 25. Conclusion: More than half of the visual impairments are treatable by provision of cataract surgery and cataract has been indicated as a priority target in the recently designed National Blindness Program of the Cape Verde Republic. Pathologic conditions such as diabetes are emerging as serious burden for ageing populations and account for most of the retinal vascular disease.