Abstract： Objective To evaluate the therapeutic effects of vitrectomy with internal limiting membrane (ILM) peeling on retinal detachment in eyes with high myopia. Methods The clinical data of 25 high myopia patients (25 eyes) with retinal detachment and macular hole were retrospectively analyzed. The patients were divided into two groups according to the treatment: 13 patients in group A had undergone conventional vitrectomy; 12 patients in group B had undergone vitrectomy and ILM peeling. All patients had been tamponaded by inert gas and kept in a face-down position for 7-15 days after the operation. The follow-up period was 6-18 months (average 10 months). LogMAR visual acuity, ocular fundus, B-scan uhrasonography and optical coherence tomography had been followed up. Results Retinal reattachment was found in 7 eyes (53.8%) in group A and 11 eyes in group B (91.7%), the difference was significant (X2=4.427, P=0.046). The macular hole closed in 6 eyes (46.2%) in group A, and 11 eyes (91.7%) in group B; the difference was significant between those two groups (X2=5.940, P=0.020). The postoperative visual acuity increased significantly in both groups (Z=-2.045, 2.481; P=0.041, 0. 012), the difference of vision improvement was not significant between those two groups (Mann-Whitnay U= 51.5, P=0.16). Conclusions By completely releasing the macular traction and increasing retinal flexibility, vitrectomy with ILM peeling can significantly increase the rate of retinal reattachment and closure of macular hole in eyes with high myopia.