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Background and Objectives: Pseudoexfoliation syndrome (PEX) is a multifactorial disease characterized by production and accumulation of a fibrillar material in ocular and many other tissues. It is the most common cause of open angle glaucoma. The purpose of the present study was to determine the serum level of zinc and copper in the serum of patients with PEX. Materials and Methods: Zinc and copper levels were measured by Atomic absorption method in the serum of 30 patients with PEX and 30 control patients with the same age and sex. Results: The copper level in serum of PEX patients was significantly higher than controls (0.003±0.001 μg/l vs. 0.002±0.001μg/l, P=0.007), but the zinc level in serum of PEX patients was significantly lower than controls (0.05±0.028 μg/l vs. 0.08±0.023 μg/l, P=0.001). There was not any correlation between copper and zinc levels in both studied groups. Conclusion: Our results suggested that increased serum level of copper in PEX may be a risk factor for systemic and ocular manifestations of this syndrome. Decreased zinc level may predispose these patients to more oxidative stress. [ABSTRACT FROM AUTHOR]