Background: The association of glaucoma with cataract has been more frequent because of increase in life expectancy and the increased risk of cataract development in patient with glaucoma. Aim of the work: was to compare the outcome of phacotrabeculectomy versus subscleral trabeculectomy with small incision cataract extraction in patients with cataract and primary glaucoma. Patients and Methods: This prospective study included a total of 20 eyes of 19 patients with visually significant cataract and coexisting primary glaucoma. Patients were categorized randomly in two groups: group A who underwent phacotrabeculectomy and group B who underwent trabeculectomy with small incision cataract extraction from the same trab. Results: Statistically significant improvement was detected in postoperative BCVA and IOP. Preoperative BCVA ranged from 0.02 to 0.25 with the mean ±SD of 0.15± (0.07) in phacotrabeculectomy group (group A) while in small incision trabeculectomy group (group B) preoperative BCVA ranged from 0.01 to 0.25 with the mean ±SD of 0.11±(0.1). Preoperative IOP ranged from 30-35 mmHg with mean ±SD of 31.28 ± (1.25) in phacotrabeculectomy group while in small incision trabeculectomy group preoperative IOP ranged from 30-36 mmHg with mean ±SD of 31.14 ± (1.34). Conclusions: It could be concluded that there is significant improvement in the BCVA and IOP control after combined procedure for management of coexistent cataract and glaucoma. This improvement is statistically significant. There was no statistically significant difference in the final visual acuity, IOP control and postoperative complication rate between phacotrabeculectomy and small incision trabeculectomy.