Moosang Kim,1 Seung-Jun Lee,1 Sang Beom Han,1 Hee Kyung Yang,2 Joon Young Hyon2 1Department of Ophthalmology, Kangwon National University Hospital, Kangwon National University Graduate School of Medicine, Chuncheon, 2Department of Ophthalmology, Seoul National University Bundang Hospital, Seoul National University College of Medicine, Seongnam, South Korea Abstract: We report, to our best knowledge, the first case of treatment of pupil-occluding postoperative organized hyphema anterior to the intraocular lens (IOL) using neodymium: yttrium-aluminum-garnet (Nd:YAG) laser. A 78-year-old Asian female underwent uneventful cataract operation. She had been taking aspirin, which she discontinued 1 week before surgery. Iris prolapse occurred at the end of the surgery, which led to intracameral bleeding. Two weeks later, her best-corrected visual acuity was hand motion. Although hyphema had decreased, pupil-occluding organized hematoma had formed anterior to the IOL. The blood clot anterior to the IOL was removed using Nd:YAG laser. One week later, although the hematoma anterior to the IOL resolved, endocapsular hematoma was observed, which was dispersed with Nd:YAG laser posterior capsulotomy. Two weeks later, her best-corrected visual acuity improved to 20/60. There was no complication associated with Nd:YAG laser. In conclusion, pupil-occluding organized hyphema anterior to the IOL can occur as a complication of cataract surgery, in which Nd:YAG laser can be a useful treatment option.Keywords: blood clot, case report, hyphema, Nd:YAG laser, postoperative hyphema