Higher order aberrations are complex optical errors that affect the quality of vision, especially in low light conditions. The article discusses the impact of higher order aberrations on the choice of intraocular lens during cataract removal surgery. These aberrations affect the patient’s vision quality after the surgery, and their analysis allows for a more precise selection of intraocular lens, increasing the chances of achieving better clinical outcomes. The article covers the main types of higher order aberrations and their impact on the choice of intraocular lens. The number of higher order aberrations changes with the patient’s age and can be the cause of suboptimal outcomes after the implantation of multifocal IOLs. Preoperative examination of the patient, taking into account higher order aberrations, is crucial for obtaining satisfactory postoperative results. Further research on higher order aberrations is essential for the development of technologically advanced intraocular lenses.