This chapter delves into the intricate landscape of retinal image quality, exploring the synergies between pyramidal aberrometry and various types of multifocal intraocular lenses (MFIOLs). As cataract surgery continually evolves, the integration of advanced imaging technologies and innovative lens designs has become pivotal in shaping visual outcomes. This chapter meticulously examines the latest developments in pyramidal aberrometry, its application in assessing MFIOL performance, and the ensuing impact on postoperative visual acuity and patient satisfaction.