Purpose To report clinical findings and characteristics of pigment dispersion syndrome (PDS) in Chinese patients. Methods PDS suspects with any one of the following signs: corneal endothelial pigmentation, iris transillumination defects (ITDs), pigment granule dusting on anterior iris surface, posterior iris bowing, trabecular meshwork (TM) pigmentation, and lenticular or zonular pigmentation were evaluated for PDS at the glaucoma specialty clinic at Beijing Tongren Eye Centre. Diagnosis of PDS required at least two of the following signs: Krukenberg spindle, moderate-to-heavy TM pigmentation (>= Scheie II) and any degree of lenticular and/or zonular pigmentation. Results Eighteen patients (12 males and six females) were identified as having PDS during a 1-year period, with mean age of 35.5 +/- 7.0 years (range, 22-49). All but two eyes from two patients had myopia of -0.5D or greater, with mean spherical equivalent power of -5.20 +/- 5.80D (range, -24.75 +/- 0.5). The average IOP at initial diagnosis was 33.7 +/- 10.5mmHg (range, 16-56). Fifteen patients (83.3%) were found to have pigmentary glaucoma at their initial diagnosis. All patients showed homogenous increased TM pigmentation as well as lenticular and/or zonular pigmentation. 61.1% of patients (11 of 18) had Krukenberg spindle. None of the patients exhibited spoke-like midperipheral ITDs except for trace-isolated transillumination in both eyes of the two patients. Conclusions The most common clinical findings in Chinese PDS patients include homogeneous TM pigmentation and pigment granule dusting on lens zonules and/ or posterior peripheral lens surface. ITDs are uncommon in Chinese patients with PDS. Eye (2009) 23, 1641-1646; doi: 10.1038/eye.2008.328; published online 7 November 2008