Hypoxia and ischemia play important roles in the onset and progression of glaucoma. Insulin‐like growth factors (IGF) are important neurotrophic agents that respond to hypoxia‐ischemia. In this study, we enrolled 60 primary open angle glaucoma (POAG) patients and 104 healthy volunteers from the China Medical College Hospital. Among the polymorphism of IGFs gene, exon 9 Apa I C/T gene polymorphism is the most frequently seen. The polymorphism was observed following polymerase chain reaction based restriction analysis used to to resolve the relationship between IGF‐II exon 9 Apa I C/T gene polymorphism and POAG. The distribution of the IGF‐II exon 9 gene polymorphism showed statistical differences in the distribution of genotype frequencies between POAG patients and normal controls (P=0.010). The odds ratio of C/C homozygote was 0.266 (95% confidence interval=0.636∼0.111). IGF‐II is an important neurotrophic agent and regulates the suffering of POAG. C/C homozygote of IGF‐II exon 9 Apa I C/T gene polymorphism is a useful marker of POAG in Chinese. J. Clin. Lab. Anal. 17:259–263, 2003. © 2003 Wiley‐Liss, Inc.