Background: Cataract surgery alone has gained more acceptance as an alternative surgical approach for primary angle closure glaucoma management. This view was supported by the recent advances in phacoemulsification and intraocular lenses, which possess a greater safety and a quicker visual recovery, in addition to a substantial reduction of intraocular pressure, deepening of the anterior chamber, and widening the filtration angle. Aim of Study:The current study is to evaluate the effects of phacoemulsification and Intraocular Lens (IOL) implantation versus phacotrabeculectomy on IOP in eyes with PACG and coexisting cataract. Patients and Methods:The current study is a randomized control study that has been conducted on 40 patients who were diagnosed to have PACG and chronic narrow angle glaucoma. Patients were recruited and followed in the Department of Ophthalmology, Mansoura University and were divided into 2 groups; (Group A) patients who underwent phacoemulsification and IOL implantation, and (Group B) patients who underwent phacotrabeculectomy and IOL implantation.