The extracellular matrix (ECM) in the trabecular meshwork is is believed to be essential for maintenance of the normal outflow system. Excessive, abnormal accumulations of ECM materials have been noted in the trabecular meshwork of eyes obtained from patients with primary open angle glaucoma. This review summarizes the current knowledge regarding the composition of this matrix and the receptors for ECM proteins in the trabecular meshwork. Modulations of the ECM elements by constituents in the aqueous humor after phagocytic challenges and by glucocorticoids are also described. The ECM is known to regulate cell differentiation and cell behavior in a number of systems. It will thus be of particular interest to establish the relationship between the modulated ECM and the functional status of trabecular meshwork cells and to examine the possible relevance of such modulation to outflow resistance.