Objective:To explore the association between infant visual acuity and neurodevelopment at 3 years of age. Methods:We employed a prospective cohort study design. A total of 1 122 children from 1 096 families enrolled in the Jiangsu Birth Cohort between August 2016 and June 2019 were included. At 1 year of age, visual acuity was measured using the Teller Acuity Card Ⅱ. At 3 years of age, neurodevelopmental status was assessed using the Bayley Scales of Infant and Toddler Development, Version Ⅲ Screening Test, covering five domains: cognition, receptive communication, expressive communication, fine motor, and gross motor. Poisson regression models were used to examine the associations between infant visual acuity and neurodevelopment at 3 years of age. Results:Among the 1 122 children, 94 (8.4% ) showed abnormal visual acuity. The prevalence of noncompetent neurodevelopment across five domains ranged from 3.5% to 10.3%. Compared with the group with normal visual acuity in infancy, the group with abnormal visual acuity had a 96% increased risk of being noncompetent development in gross motor domain at age 3 (RR=1.96, 95% CI 1.03- 3.70). This association remained stable after excluding twins, preterm infants, low birth weight infants and children conceived via assisted reproductive technology. Conclusion:Abnormal visual acuity in infancy was associated with an increased risk of being noncompetent in gross motor development at 3 years of age.