Purpose To evaluate the cerebral haemodynamics in patients with pseudoexfoliation glaucoma. Methods A total of 19 consecutive patients with pseudoexfoliation glaucoma and 19 ageand sex-matched healthy volunteers were recruited in a prospective comparative study. The affected eye in patients with unilateral glaucoma and the eye with more advanced lesions in patients with bilateral glaucoma were included in the study, and the ipsilateral middle cerebral arteries (MCA) were evaluated. While in the controls, the study eye and the ipsilateral MCA were chosen randomly. Measurements included systemic arterial pressure, heart rate, intraocular pressure (IOP), and transcranial colour Doppler parameters, including peak systolic velocity (PSV), end-diastolic velocity (EDV), time-averaged maximum velocity (TAMAX), resistivity index (RI), and pulsatility index (PI). Results The mean PSV, EDV, and TAMAX were significantly lower in the patients with pseudoexfoliation glaucoma than in healthy controls (Po0.001, o0.001 and o0.001, respectively). Additionally, patients with pseudoexfoliation glaucoma had significantly higher PI and RI than healthy controls (P ¼ 0.001 and 0.04, respectively). Systolic and diastolic blood pressures (P ¼ 0.19 and 0.91, respectively) and heart rate (P ¼ 0.06) were not different between the groups. The mean IOP were significantly higher in the glaucoma patients compared with the controls (Po0.001). Conclusion This study suggests that pseudoexfoliation glaucoma is associated with a reduction in the blood flow velocity and elevation in the resistance of the MCA.