OBJECTIVE To describe the indications and results of pars plana vitrectomy for rhegmatogenous retinal detachment in patients born prematurely. PATIENTS AND METHODS Between 1995 and 2001, primary vitrectomy for retinal detachment was performed in a consecutive series of 11 eyes of 10 patients. Gestational age ranged from 26 to 30 weeks, and birth weight ranged from 810 g to 1475 g. RESULTS Myopia was found in 9 of 11 eyes. Two patients initially had a vitreous hemorrhage. One of these children was previously treated with cryotherapy during the acute phase of stage 3+ retinopathy of prematurity. Three eyes had a normal posterior pole and only mild peripheral retinal changes. Primary vitrectomy was performed in all 11 eyes. Patients received follow-up for 7.2 months to 6.6 years (mean, 2.7 years). Three eyes with severe cicatricial changes due to retinopathy of prematurity needed multiple procedures with silicone oil tamponade for reattachment. In 10 (90%) of 11 eyes, the retina was completely attached at the last follow-up visit. Visual acuity ranged from light perception to 20/25 in the affected eye. CONCLUSIONS Patients born prematurely may develop late-onset retinal detachment due to vitreoretinal changes caused by retinopathy of prematurity. Primary vitrectomy is an effective treatment technique for retinal detachment in patients born prematurely.