Objective To evaluate the effectiveness and safety of phacoemulsification and viscogoniosynechialysis in managing refractory acute angle-closure glaucoma （ACG）. Methods This was a retrospective case series. The medical records of 23 patients（25 eyes） with refractory primary acute angle-closure glaucoma who underwent combined phacoemulsification and viscogoniosynechialysis from March 2011 to June 2012 at Peking Union Medical College Hospital were examined. Eyes were divided into an atonic pupil group （12 eyes） and a normal pupil group （13 eyes） based on pupil function. Phacoemulsification and viscogoniosynechialysis were performed and a 4.5 mm diameter continuous curvilinear capsulorhexis （CCC） was made in the atonic pupil group. Intraocular pressure （IOP）， visual acuity， anterior chamber depth （ACD） and need for drops were recorded with a mean follow-up of 23.5±6.2 months （18-33 months）. Pre- and post-operative data were compared with a paired-samples t test. Intraocular pressure curves of the atonic pupil group and normal pupil group were plotted. Complications and treatments were recorded. Results Significant differences were found preoperatively and postoperatively for mean IOP （38.20±6.04 mmHg vs. 15.20±2.41 mmHg）， BCVA （1.03±0.53 vs. 0.13±0.20）， anterior chamber depth （1.92±0.18 mm vs. 2.58±0.26 mm） and number of antiglaucoma medications （2.96±0.89 vs. 0.20±0.81） （P<0.01）. One patient （4%） had two complications and 1 patient （4%） had 1 complication. Conclusion Combined phacoemulsification and viscogoniosynechialysis is an effective and relatively safe procedure to relieve an episode of laser and medically unresponsive ACG.