Pigmentary glaucoma is a secondary open-angle glaucoma characterized by homogenous brownish pigmentation of the chamber angle, pigment deposition on the corneal endothelium (the ‘Krukenberg spindle’) and slit-like, radial, midperipheral transillumination defects of the iris. The pathophysiology of PG considers two major mechanisms following as the mechanics of pigment dispersion and obstruction of aqueous outflow. This chapter covers the demographics and symptoms, clinical exam findings, differential diagnosis, and management. Pigmentary glaucoma is typically seen in myopic, young adult males. Medical treatment is similar to other forms of open-angle glaucoma. Regarding laser treatment, future research will better elucidate the most efficacious and safe modalities, including laser trabeculoplasty and peripheral iridotomy.