Uveitis-glaucoma-hyphema (UGH) syndrome is a rare condition characterized by intraocular inflammation, elevated intraocular pressure, and recurrent hyphema. Although UGH syndrome is typically caused by chafing between an intraocular lens and the iris or ciliary body, microinvasive glaucoma devices are becoming increasingly recognized as potential causes of recurrent intraocular inflammation. Herein, we discuss a case of UGH syndrome due to subtle malposition of a Hydrus microstent that ultimately required surgical removal to manage. This represents the first case of Hydrus-related UGH syndrome to include high-quality anterior segment imaging, which led us to suspect Hydrus-iris contact and supported the decision to proceed with microstent explantation.