Minimally invasive glaucoma surgery aims to provide a safer and less-invasive means of reducing IOP compared with traditional surgery, with the goal of reducing the need for topical medications. The XEN gel stent is an ab-interno minimally invasive glaucoma surgery device that approaches intraocular pressure reduction by creating a subconjunctival drainage pathway. As with any new device there is lack of experience and knowledge about its long-term results in terms of efficacy, technique, and complications. We report a clinical case of a XEN blood clot internal ostium obstruction and how it was managed. The ab-interno approach with microforceps seems a minimally invasive, safe, and effective procedure.