Surgical treatment of glaucoma is directed toward altering aqueous humor production, drainage, or a combination of both. Increased intraocular pressure is a constant risk factor; addressing this factor represents the only treatable and measurable component in terms of successful glaucoma treatment. The optimal candidate for surgery is able to see, is in an early disease stage and has a normal optic nerve head without additional conditions. Dogs with a persistent high eye pressure, despite maximum levels of medical treatment, also qualify. Although the spectrum of medical and surgical therapies keeps growing, there is still no successful cure, and many affected dogs become blind. Regularly, eyes are enucleated because of painfully high, uncontrollable intraocular pressure. Because newly developed glaucoma medications are emerging at a very slow rate and may often not be effective in dogs, research toward improving surgical options may be the most rewarding approach in the near future.