Experience in managing five eyes with glaucoma associated with the Sturge-Weber syndrome is presented. All cases were treated with a combined trabeculotomy-trabeculectomy as the primary surgical procedure. A review of the proposed mechanisms involved in the glaucoma of this syndrome is given to provide the reasoning behind the selection of this operation. Although the results of this small series do not prove superiority of this surgical approach over techniques reported by others, we feel that a combined operation of this type offers the most reasonable hope for success, until a more precise understanding of the glaucoma mechanism in this condition is established.