OBJECTIVE To determine the mean visual improvement after internal limiting membrane (ILM) peeling assisted with brilliant blue staining of ILM in macular hole, and stratify the mean visual improvement in different stages of macular hole. STUDY DESIGN Quasi-experimental study. PLACE AND DURATION OF STUDY Eye outpatient department (OPD), Lahore General Hospital, Lahore from October 2013 to December 2014. METHODOLOGY Patients with macular hole underwent measurement of best corrected visual acuity (BCVA) and fundus examination with indirect slit lamp biomicroscopy before surgery. The diagnosis of all patients was confirmed on optical coherence tomography. All patients had 23G trans-conjunctival three ports pars plana vitrectomy, ILM peeling, and endotamponade of SF6. The mean visual improvement of different stages of macular hole was noted. Paired t-test was applied. RESULTS There were 30 patients, 15 males and 15 females (50%). The mean age was 62 ±10.95 years. They presented with low mean preoperative visual acuity (VA) of 0.96 ±0.11 logMar. The mean postoperative VAwas 0.63 ±0.24 logMar. The mean visual increase was 0.33 ±0.22 logMar (p < 0.001). In patients with stage 2 macular hole, mean visual increase was 0.35 ±0.20 logMar (p < 0.001). In patients with stage 3 macular hole, mean visual increase was 0.44 ±0.21 logMar (p < 0.001), and in patients with stage 4 macular hole it was 0.13 ± 0.1 logMar (p = 0.004). CONCLUSION ILM peeling assisted with brilliant blue is a promising surgery for those patients who have decreased vision due to macular hole, in 2 - 4 stages of macular hole.