Objectives: To evaluate the effect of hormone replacement therapy (HRT) on intraocular pressure (IOP) in menopausal women. Methods: The IOP of 25 white menopausal women without an abnormal ophthalmologic history was measured before and during HRT regimen. IOP fluctations were recorded before and 1, 4, and 12 weeks after the beginning of HRT. These measurements were obtained according to a standardized time schedule (08:00, 12:00, 16:00, and 19:00 h). Results: The mean IOP in the left eye decreased from 16.2 ± 2.4 mmHg before therapy to 14.0 ± 2.1 mmHg after 12 weeks of therapy (P<0.001). In the right eye, whose IOP was at 15.3 ± 2.3 mmHg before therapy there was a decrease to 14.0 ± 1.9 mmHg after 12 weeks of therapy (P<0.001). Conclusion: Hormone replacement therapy has a positive effect on IOP in menopausal women.