A prospective clinical study of the anterior chamber angle was performed in 263 eyes (152 patients) with pseudoexfoliation syndrome (PSX). No significant difference was found in width and depth of the anterior chamber in comparison with normal population. We found a significative correlation (p less than .0001) between the increase of intraocular pressure (IOP) and the degree of diffuse pigmentation in trabecular meshwork and the Sampaolesi line. When we confronted the two eyes of the same patient, we found that the IOP was greater in the eye with higher pigmentation; and the higher was the difference of pigmentation between the two eyes, the higher was the difference in IOP (p less than .0001). No relation was found between PSX material in angle and IOP. In 24.7% of eyes, we noticed large iris processes, without goniodysgenesis. The results show a significative correlation between the pigmentation of the trabecular meshwork and the IOP.