Glaucoma drainage devices may be indicated in glaucoma associated to complex congenital anomalies or dysgenesis of the anterior segment, secondary glaucomas such as those developed after congenital cataract surgery, severe primary congenital glaucoma after failed angle surgery and in eyes with severe conjunctival scarring. They can be combined with several other procedures, such as cataract extraction, intraocular lens implantation, keratoplasty or pars plana vitrectomy. This procedure may achieve a sustained and prolonged intraocular pressure reduction in children, with early post-operative success as high as 90 %, although it decreases over time, to 40–60 % survival at 4–6 years using the Kaplan-Meier analysis and most children need to reinitiate glaucoma treatment postoperatively. We must bear in mind that complications may occur, especially tube malposition and exposure, and multiple repeated surgeries may be necessary. The advantages and complications should be weighed in each individual case.