AIM:To evaluate the therapeutic efficacy and safety of trabeculectomy for primary acute angle-closure glaucoma(PACG) with high intraocular pressure (IOP)． METHODS:Fourty-eight cases (50 eyes) of PACG were retrospectively analyzed，which underwent trabeculectomy. These cases were divided into 2 groups by the preoperative IOP： the operation group (12 eyes，IOP≥40mmHg)，and the control group (38 eyes，IOP＜40mmHg)．The IOP，visual acuity，complications and surgery outcome of both groups were compared． RESULTS: No severe complications such as choroidal hemorrhage，malignant glaucoma were observed in both groups during surgery and postoperation．The success rate of operation in the control group was much higher than that in the operation group shortly after the operation with significant difference (P=0.0332）．But the success rate of both groups had no significant difference（P＞0.05）in return visit． CONCLUSION:Trabeculectomy for PACG with persistent high IOP should be performed actively to avoid further damage to the visual function．