BACKGROUND We aimed to evaluate the efficacy and safety of pneumatic trabeculoplasty (PNT) and selective laser trabeculoplasty (SLT) in the treatment of primary open-angle glaucoma (POAG) and ocular hypertension (OHT). MATERIAL AND METHODS We randomly divided 120 cases (120 eyes) of POAG or OHT into 2 groups: PNT and SLT. The changes in anterior chamber angle, intraocular pressure (IOP), treatment effect, macular retinal ganglion cell complex (GCC) thickness, visual field, adverse reactions, and complications were observed before and 3 months after treatment. RESULTS In the PNT group, the opening range of anterior chamber angle at 1 week, 2 weeks, 1 month, and 3 months after surgery was significantly larger than that before surgery. In the SLT group, the open range of anterior chamber angle was significantly less than that before surgery at 1 week and 2 weeks after surgery. The open range of anterior chamber angle in the PNT group was significantly larger than that in the SLT group at 1 week, 2 weeks, 1 month, and 3 months after surgery. The mean IOP of the 2 groups decreased significantly after surgery. The postoperative mean IOP of the SLT group was significantly higher than that of the PNT group, and the decrease of IOP in the PNT group was significantly greater than that of the SLT group. The effective rate of the PNT group was higher than that of the SLT group. CONCLUSIONS Both PNT and SLT can reduce the IOP of patients with POAG and OHT. PNT appears to have better short-term treatment efficiency than SLT.