To compare the risk of early intraocular pressure (IOP) spikes following micropulse (MP) vs continuous wave (CW) transscleral cyclophotocoagulation (CPC). Single-center, prospective, nonrandomized study that included glaucoma patients planned for MP- or CW-CPC at Wills Eye Hospital (2020-2021). IOP was measured using rebound tonometry (iCare) immediately before, immediately after, and 1 hour after the CPC, then on postoperative day 1. The primary outcome measure was the incidence of IOP spikes, defined as IOP elevation ≥10 mm Hg vs baseline. Patients with severe IOP spikes received IOP-lowering agents (topical or oral). Twenty-six eyes (15 CW and 11 MP) of 26 patients were included, with a mean age of 64.4 ± 15.1 years. At the baseline visit, IOP was 29.5 ± 11.3 mm Hg, and the medication number was 3.8 ± 1.4, with no difference between groups. IOPs (CW vs MP, mm Hg) were 31.9 ± 10.5 vs 24.1 ± 7.3 immediately before CPC (p = 0.044), 22.9 ± 10.8 vs 16.1 ± 6.3 immediately after CPC (p = 0.760), 24.6 ± 11.9 vs 23.2 ± 9.5 at 1 hour after CPC (p = 0.757), and 18.0 ± 6.1 vs 20.8 ± 6.9 at 1 day later (p = 0.335). Three eyes (11.5%; 1 CW, 2 MP) experienced IOP spikes (p = 0.556) at 1 hour post-CPC; IOP responded to topical and/or oral medications. At day 1 and month 1, mean IOP reduction compared to baseline was significant in CW eyes (p < 0.001) and insignificant in MP eyes (p > 0.05). MP- and CW-CPC have similar risks of early postoperative IOP spikes. Significant early IOP reduction was better achieved following CW-CPC. Early postoperative IOP spikes may be detrimental; there may be a role for IOP monitoring in such cases. Understanding the early postoperative outcomes of MP- and CW-CPC is critical for optimizing glaucoma management. This study highlights that while both procedures carry a similar risk of early IOP spikes, CW-CPC demonstrates superior early IOP reduction. These insights help clinicians tailor CPC strategies to individual patient requirements. Shalaby WS, Arbabi A, Wong J, et al. Early Postoperative Intraocular Pressure Profile Following Micropulse vs Continuous Wave Transscleral Cyclophotocoagulation: Cohort Study. J Curr Glaucoma Pract 2025;19(1):8-14.