Epithelial downgrowth is a rare yet serious complication after ocular trauma or anteriorsegmental surgery. It can lead to decompensation of corneal endothelium, secondary glaucoma or other serious complications, among which refractory glaucoma is the main cause of enucleation. It is vital to raise the awareness of this disease and take strict precautions against it. We present a case of epithelial downgrowth and discuss the risk factors, pathogenesis and preventive measures of the disease through analyzing clinical data and pathological sections.