A case with postoperative elevated intraocular pressure levels caused by massive and prolonged hemorrhage after trabeculotomy ab externo is presented. In this case, intraocular pressure was controlled by removal of the hemorrhage, but the transient elevation resulted in progression of visual field defect. Thus, resorption of hyphema and intraocular pressure levels should be monitored closely after trabeculotomy, and surgical removal of the hemorrhage appears to be an effective treatment for this rare complication.