Background: Visual impairment and blindness is one of the leading causes of disability worldwide and have profound socio economic impact. Though, visual impairment can lead to permanent disability, some are preventable or curable if detected in an early stage. Knowledge of various causes of visual impairment through frequent regional evaluation can be helpful in planning and management. Aim: To find out the causes of visual impairment and blindness among patients applying for disability certificate in tertiary care hospital in Assam. Material and Method: A Hospital based retrospective study to analysed the causes of visual impairment blindness among applicants for visual disability certificate a period of one year. The degree of visual impairment was estimated as per the Ministry of Social Justice and Empowerment, Govt. of India Guidelines. Results: Out of 186 applicants 146 were accepted for visual handicap certificate. Out of which 88 (60.27%) were male and 58 (39.72%) were female. Most common age group of was 20-40 years. In this study, 36.30% had some congenital anomaly and the rest 63.70% had acquired disorders. Among the congenital disorders Congenital microphthalmos and Anophthalmus was found to be most common, followed by coloboma of eye, while Diabetic retinopathy and as complication was the most common Acquired condition followed by refractive error and amblyopia. Conclusion: Regional data regarding leading causes of visual impairment is helpful not only im institutional level for better management of cases, but also for planning and implementation of various government plans and It also identifies unique need of a particular region.