Objective  To evaluate the influence of Ahmed glaucoma valve implantation on the corneal endothelium during a one-year follow-up period. Methods  In a retrospective case study， 21 patients （21 eyes） with refractory glaucoma underwent Ahmed glaucoma valve implantation. The corneal endothelium was assessed by spectral microscopy 1 day preoperatively and 1 week and 1， 3， 6 and 12 months postoperatively. Density and loss ratio of the corneal endothelium cells were assessed and calculated. Intraocular pressure （IOP）， anterior chamber depth （AC） and the position of the drainage tube were also observed. An analysis of variance （ANOVA） was used to compare corneal endothelial cell density at the different time points. Results  The density of corneal endothelium cells decreased after Ahmed glaucoma valve implantation in all 21 eyes. The loss ratio of the corneal endothelium increased over time. Compared to a preoperative value of 2306±229 cells/mm2， the corneal endothelium at 1 week postoperatively was 2299±234 cells/mm2， at 1 month was 2062±234 cells/mm2， at 3 months was 2015±223 cells/mm2， at 6 months was 1999±222 cells/mm2， and at 12 months was 1901±210 cells/mm2 （F=15.3， P<0.01）. The loss ratio of the corneal endothelium were 0.3%， 10.5%， 12.6%， 13.2%， 17.5%. Conclusion  There is a loss in corneal endothelium during the short time period after Ahmed glaucoma valve implantation.