Background:Pseudoexfoliation (PEX) syndrome is one of the identifiable cause cataract worldwide. The reported prevalences in different parts of the world have varied from 0% to 38% in different populations. Aim:Our study, we report the prevalence and complications of PEX syndrome in a rural population in southern and northern India. Methods:1000 patients each from 6 geographically contiguous districts around Coimbatore district of the state of Tamil Nadu in South India and 6 geographically contiguous districts around Kanpur district of the state of Uttar Pradesh in North India for 1 year. Ophthalmic evaluation included recording of relevant ocular and medical history, were recorded. Results:1000 patients examined in South & North India, 600 people & 300 people had farming as their major occupation respectively. In south India, 100 (10%) were found to have PEX syndrome, whereas in North India, it was 60 (6%). The sex distribution reported a female preponderance. The mean age of subjects with PEX syndrome is 11.16 years older than the normal population. Conclusion:Majority of study population in South India had farming as occupation with an average of 12-16 hours exposure to direct sunlight whereas in North India, majority were labourers with an average of 6-8 hours exposure to sunlight. More solar rays can reach the eye during the earlier decades of life as pupil size is known to be larger with younger age. This may be the most likely explain as to why pseudoexfoliation syndrome is more common among South Indians as compared to North Indians