Neovascular glaucoma is a disease entity marked by pathological angiogenesis within the iris and drainage angle, secondary to retinal ischemia. The clinical course typically progresses through three successive stages: rubeosis iridis, secondary open-angle glaucoma, and, ultimately, secondary angle-closure glaucoma accompanied by significantly elevated intraocular pressure and severe ocular pain. This condition poses a substantial therapeutic challenge, as it most often arises following acute ischemic events – such as central retinal vein occlusion – or during advanced stages of chronic retinal vascular diseases, primarily diabetic retinopathy. Although neovascular glaucoma is a relatively uncommon complication, if left untreated, it can lead to blindness. Preventive strategies focus on managing the underlying disease, as the metabolic disturbances associated with diabetes mellitus contribute to the progression of vascular changes within the eye. Diagnostic management is based on the early detection of neovascularization. Slit-lamp examination, tonometry, gonioscopy, and imaging studies constitute the standard of care. The prognosis is serious, and the range of therapeutic options is broad – from conservative treatment to surgical intervention – allowing for considerable individualization of therapy. Importantly, therapeutic success depends not only on controlling intraocular pressure, but above all on achieving metabolic stabilization of the patient’s diabetes.