Purpose: This study aimed to evaluate changes in anterior segment morphology and intraocular pressure (IOP) in patients with acute angle-closure glaucoma (AACG) following early phacoemulsification, using Scheimpflug-Placido disc tomography. Methods: In this retrospective cohort study, 32 eyes of 32 phakic patients diagnosed with AACG and referred to a tertiary hospital between 2021 and 2023 were included. After medical stabilization of IOP and inflammation, all patients underwent cataract surgery within 1 month of the acute attack. Anterior segment parameters were assessed using Scheimpflug-Placido disc tomography before and 1 month after surgery. Paired t-tests were used for statistical analysis. Results: The mean age of patients was 65.76 ± 9.63 years. Postoperatively, best-corrected visual acuity improved significantly (preoperative, 0.81 ± 0.92 logMAR; postoperative, 0.18 ± 0.30 logMAR; p < 0.01). Mean IOP decreased by 22.80 ± 3.45 mmHg (p < 0.01). Significant increases were observed in iridocorneal angle (from 24.62° ± 9.59° to 46.20° ± 10.93°), anterior chamber depth (from 1.34 ± 0.65 to 3.02 ± 0.82 mm), and anterior chamber volume (from 98.01 ± 28.62 to 145.87 ± 27.27 mm3), all with p < 0.01. Central corneal thickness decreased slightly but significantly (from 579.80 ± 47.48 to 556.80 ± 47.29 μm, p = 0.03). Conclusions Early lens extraction in AACG significantly improves anterior segment parameters and lowers IOP. Scheimpflug- Placido disc tomography is a useful noninvasive tool to quantify these changes.