Pseudophakic bullous keratopathy (PBK) is irreversible stromal edema in the cornea, resulting from injury to the corneal endothelium, most commonly occurring after intraocular surgery. While any intraocular surgery can potentially cause endothelial damage, PBK most commonly occurs after cataract surgery. Advancements in cataract surgical technique and IOL design have reduced the incidence of PBK, but a common indication for a corneal transplant in many parts of the world remains corneal edema following cataract surgery. The introduction of novel intraocular devices may be an emerging etiology for endothelial decompensation. The rapid evolution of endothelial keratoplasty over the past few decades has improved surgical management of bullous keratopathy. Current therapies are being investigated to treat endothelial dysfunction using cell-based therapy.