AIM:To discuss the operational timing choosing and the technical details of primary angle-closure glaucoma (PACG) in high intraocular pressure. METHODS:The curative effects of 57 cases (57 eyes) with PACG of our hospital in two years ( January 2009 to December 2010) were retrospectively analyzed, these cases were treated with surgical therapy in high intraocular pressure (>40 mmHg). RESULTS:There was no complication in these cases. Followed up for six months, the vision of 53 eyes (93%) were improved and 4 eyes (7%) were not improved; intraocular pressure of 48 eyes (84%) treated with surgery and 9 eyes (16%) treated with combinations of surgery and drug administration were controlled under 21mmHg. CONCLUSION:If the intraocular pressure can not lowered to normal level through regular drug administration for the acute onset of PACG, there is an emergent need for surgical measure to protect and recover the vision of patients.