Objective: To explore the association between infant visual acuity and neurodevelopment at three years of age. Methods: This study was based on the Jiangsu Birth Cohort and employed a prospective cohort study design. A total of 1,122 children from 1,098 families enrolled in the Jiangsu Birth Cohort between August 2016 and June 2019 were included. At one year of age, visual acuity was measured using the Teller Acuity Card II. At three 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 three 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 three (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 three years of age.