Trabeculectomy and seton implantation are commonly performed for glaucoma refractory to medical therapy. The use of antifibrotic agents such as mitomycin C and 5-fluorouracil have improved the long-term success of glaucoma surgery while leading to higher complication rates such as bleb leakage and infection. Despite the use of these medications, glaucoma surgery often fails because of excessive scar formation. Bleb needling procedures with or without antifibrotics are often used to reestablish flow. Antineovascular agents may augment the success rate of bleb needling while limiting the influx of fibroblast-stimulating cytokines carried within encroaching vessels. We describe our technique for bleb needling with bevacizumab in patients failing trabeculectomy or seton implantation.