Introduction Glaucoma presents an ever-increasing burden in Africa because of its asymptomatic nature. In South Africa, pseudoexfoliation syndrome (PXS) is particularly prevalent among black South Africans patients with glaucoma. The objective of the study was to determine the prevalence of PXS in a population of patients attending a glaucoma clinic; and to ascertain its clinical features. Materials and methods This was a cross-sectional survey of patients attending a glaucoma clinic in rural Eastern Cape. A sample of 100 patients were selected for the study and data was collected using a questionnaire and by doing a clinical examination. Data was analysed in Epi-info to determine prevalence, clinical features, and chi square test to determine association between PXS and socio-demographic factors and the severity of glaucoma. Results A total of 100 patients attending the clinic were included in the study. The majority of patients were male (59%); in their 60s; of rural origin (63%); and did not have any tertiary education (74%). Of note is that 84% of the patients had Primary Open Angle Glaucoma (POAG). The prevalence of pseudoexfoliation syndrome in these patients was 13%. All 13 PXS had the central round disc of PCE material on the lens capsule and a peripheral ban of PXS and a clear zone in between and PXS material was visible on the papillary margin in all cases. Conclusion This study shows a prevalence of 13% which is in keeping with other figures of previous South African studies which vary between 8.1% and 21.6%.