Background: Glaucoma is the most frequently reported complication post congenital cataract surgery. Lens status (aphakia or pseudophakia) appears to have a direct role in the development of glaucoma post-surgery although the mechanism is not well understood. Aim: To determine the incidence of aphakic and pseudophakic glaucoma in our population, common complication post-cataract extraction surgery. the effect of early implantation of intraocular lens on development of glaucoma, reviewing the medical and surgical options on managing glaucoma patients and their visual outcomes. Methods: This is an analysis of patient records who underwent congenital cataract surgery in a single center in Saudi Arabia between the years 2008 and 2018. All patients gave informed consent and data collection was done in a manner consistent with patient privacy standards and approved by the center’s ethics board. Data were tabulated in MS excel and all statistical data were analyzed in SPSS version 21. Results: A total of 199 patients were included in the study. Glaucoma incidence in this sample was 20.2% overall 11.1% were aphakic and 10.1% were pseudophakic. Glaucoma in the psudophakic group developed at a later time compared to the aphakic group (66.9 ± 24.3 months vs 24.6 ± 33.1 months; P<0.001). The mean age when IOL inserted in glaucoma patients was significantly longer when compared to normal pseudophakic patients (T=-1.805; p=0.004). More than a half of patients (51.4%) used only one medication with 40.5% of them reported to have additional surgery. The most commonly cited type of surgery was trabeculectomy (41.2%), followed by tube surgery (35.3%). Conclusion: glaucoma post congenital cataract surgery is difficult entity. The incidence of aphakic glaucoma group was higher in comparison to psudophakic glaucoma group. The delay in IOL implantation was a risk factor for developing glaucoma. Trabeculectomy was the surgery of choice when manging glaucoma in these patients. The prognosis is guarded life-long follow up is mandatory.