The records of 48 patients with persistent hyperplastic primary vitreous (PHPV) were reviewed. Approximately 17% had vision of 20/100 or better after surgery, contact lens fitting, and amblyopia therapy. Only eyes with a purely anterior presentation had successful visual outcomes. Lensectomy alone prevented glaucoma, but a membranectomy as well was required to ensure a successful visual result. Eyes with a posterior PHPV had poor visual results because of posterior pole abnormalities. I recommend that an attempt be made to visually salvage eyes with an anterior presentation. Eyes with a posterior or a combination anterior-posterior PHPV can be successfully treated for glaucoma, but the visual results will be poor.