OBJECTIVE: To assess the safety and efficacy of the triple procedure of extracapsular cataract extraction (ECCE), lens implant and trabeculectomy in cataract and glaucoma patients. STUDY DESIGN: Retrospective study of postoperative results with a minimum follow-up of 14 months. SETTING: Ophthalmic Department, Treviso Hospital, Italy. PATIENTS: One hundred and five eyes of 82 patients suffering from cataract and glaucoma. MAIN OUTCOME MEASURES: Best corrected visual acuity, keratometry, intraocular pressure, visual field, number of medications, complications. RESULTS: Intraocular pressure (IOP) decreased from 25.26 ± 6.12 (m ± DS) mmHg to 16.72 ± 4.08 (m ± DS) mmHg and visual field stabilization was obtained in 89 eyes. Visual acuity of 0.5 or better was obtained in 59% of eyes. Visual significant postoperative complications occurred in only seven eyes. CONCLUSION: The triple procedure of ECCE, lens implantation and trabeculectomy provided satisfying visual rehabilitation and IOP control, in a single operation, avoiding dangerous postoperative IOP spikes. Visually significant complications appeared minimal.