Primary angle closure glaucoma is a common cause of visual loss worldwide. Gonioscopy and other current methods of assessment of the anatomy of the anterior segment relevant to the diagnosis of this disease, such as ultrasound biomicroscopy, have significant limitations. Anterior segment optical coherence tomography, with its rapid, noncontact, and high-resolution image acquisition, seems to be a promising tool for the evaluation of the anterior chamber angle configuration, including changes induced by illumination and laser peripheral iridotomy. It has the potential for use as a rapid screening tool for detection of occludable angles. Ongoing clinical studies should help to evaluate its efficacy in this regard.