An evaluation of 100 consecutive patients in whom the exfoliation syndrome was detected as an incidental finding revealed the incidence of glaucoma to be lower than previously reported. There were 75 women and 25 men in the study. Seventy-six patients had unilateral and 24 patients had bilateral involvement. The mean age of the unilateral group was 70 years and that of the bilateral group, 71 years. Of 124 eyes having the exfoliation syndrome, 78% had normal intraocular pressure, 15% had ocular hypertension (intraocular pressure greater than 22 mm Hg but no cupping or field loss), and 7% had glaucoma. Women out-numbered men in normotensive and ocular hypertensive groups, but no sex difference was apparent in the group with glaucoma. In the 76 patients in the unilateral group, 13 eyes having the exfoliation syndrome had ocular hypertension, and three had glaucoma. In five of the 16 patients with ocular pressure abnormalities in the eye with exfoliation syndrome, the fellow eye had ocular hypertension.