Anterior ocular segment pathologies associated with anterior chamber and /or iris anomalies can be congenital and acquired. Surgical treatment is important for visual functions rehabilitation. We present a review on some cases of congenital and acquired anterior ocular segment anomalies. The congenital anomalies are presented by Peters type II syndrome, anterior chamber dysgenesis, iris coloboma with significant pupillary ectopy; the acquired pathologies are presented by anterior chamber deformities caused by large anterior synechia, adherent leucoma, associated with postoperative aphakia or traumatic cataract. The surgical options included anterior synechia excision, 360-degree synechiolysis, pupilloplasty, anterior vitrectomy, basal iridotomies, cataract extraction, and intraocular lens implantation. The postoperative recovery underwent without complications. We checked for the presence of any inflammatory reaction (mild or moderate), corne (with opacitie still being present in case with Peters anomaly), anterior chamber depth (adequate), intraocular lens position (centered) and intraocular pressure (in normal ranges, though in the cases with Peters anomaly, it was controlled with a topical IOP lowering medication). Surgery for congenital and acquired anterior ocular segment pathologies is challenging and need individual approach, multiple maneuvers at a single surgical step and permanent postoperative state control.