Background: Glaucoma is a group of potentially blinding ocular condition which broadly involves a defect in the drainage angle, raised intraocular pressure, optic nerve head damage and visual field loss. Goal of glaucoma surgery is to preserve and enhance the patient’s quality of life. Aim: The purpose of this randomized clinical study was to evaluate and compare microtrabeculectomy with conventional trabeculectomy in the management of primary open angle glaucoma. Materials and Methods: Fifty eyes of forty–seven patients were randomized to have a microtrabeculectomy (25 eyes) or a conventional trabeculectomy (25 eyes) by one surgeon and followed up prospectively for 6 months. Results: The mean intraocular pressure at presentation was 41.38 mmHg in microtrabeculectomy group and 36.8 mmHg in conventional trabeculectomy group. After 6 months of follow up, the mean intraocular pressure was 13.8 mmHg in microtrabeculectomy group and 14.97 mmHg in conventional trabeculectomy group (p < .0001). Mean fall in intraocular pressure in Group–I was 66.65% and in Group–II was 59.51%. In Group–I, 84% patients had absolute success, 12% qualified success and 4% failure, whereas in Group–II, 80% patients had absolute success, 16% qualified success and 4% failure. Conclusion:.Microtrabeculectomy allows the surgeon to perform a controlled procedure with less tissue disruption and a chance of success that is at least equivalent to conventional trabeculectomy.