Combined phacoemulsification and trabeculectomy has become a common procedure in the management of coincident cataract and glaucoma. As the medical options to treat glaucoma continue to improve, more patients may not require surgical intervention until the time of cataract extraction. Current techniques using small-incision phacoemulsification and trabeculectomy with antimetabolites have vastly improved the results of combined glaucoma surgery. This article discusses many of the important issues as they relate to this subject. This is not a comprehensive review, but rather a discussion of the literature in the scanning period of this issue.