Night Vision Disturbances (NVD), including glare, halos, starbursts, and ghosting, are among the most common complaints following refractive surgery, significantly impacting patients’ quality of life, particularly during activities like night driving. These disturbances arise from multifactorial causes, with higher-order aberrations (HOAs) being a key contributor. The wide range of illumination levels, from scotopic to mesopic conditions, exacerbates these symptoms, making NVD a frequent post-surgical concern. No gold-standard clinical test exists to quantify NVD, with subjective questionnaires being the most used diagnostic tool. Optimized aspherical ablations and topography-guided refractive surgery have shown promise in minimizing HOAs and reducing NVD incidence. These advanced techniques help address the optical imperfections that lead to symptoms like halos, which occur when the pupil diameter exceeds the optical zone diameter, and glare, caused by light scattering within the ocular media. Fortunately, most NVDs tend to decrease over time, making observation the primary therapeutic option. However, understanding and addressing contrast sensitivity loss, glare disability, and image degradation are crucial for improving patient satisfaction. Refractive surgeons must consider these factors during preoperative planning and surgical technique selection to optimize visual outcomes and minimize postoperative NVD.