OBJECTIVES: To investigate the cost-effectiveness of a hypothetical community screening and subsequent treatment programme for glaucoma in comparison with current practice (i.e. with no screening programme but with some opportunistic case finding), in both urban and rural areas of India. METHODS: A decision analytical model was built to model events, costs and treatment pathways with and without a hypothetical screening programme for glaucoma for a population aged between 40-69 years age in urban and rural areas. The treatment pathway included both primary open-angle glaucoma and angle closure disease. Screening and treatment costs were obtained from an administrator of a tertiary eye hospital in India. The probabilities for each pathway (i.e. for urban and rural areas) were derived from published literature and expert opinion (Glaucoma specialist currently practicing in India). The glaucoma prevalence rates for urban and rural areas were adapted from the Chennai Glaucoma Study findings. Separate decision analytical models for urban and rural areas were built for calculating the cost-effectiveness of community screening for glaucoma in comparison to current practice (i.e. no screening programme with some opportunistic case finding). The outcomes calculated were the incremental cost of screening (i.e. compared with no screening), the additional cases treated with screening; and the cost per QALY gained by screening. RESULTS: The introduction of a community screening programme for glaucoma is likely to be cost-effective, the estimated ICER values being ₹ 8312.71 for urban areas and ₹ 7292.30 for rural areas, when compared with no screening programme. The community screening for glaucoma would treat an additional 4443 cases and 2872 cases, and prevent 1790 person-years of blindness, and 1150 person-years of blindness over a 10-year period, in urban and rural areas respectively.  CONCLUSIONS: If adequate resources (trained medical personnel and equipment) is available the likelihood of community screening for glaucoma to be cost-effective and have an impact on reducing glaucoma-related blindness burden, remains high in India.