This chapter deals with the current management strategies of some selected important posterior segment disorders, wherein surgery is the mainstay of management—namely rhegmatogenous retinal detachment; proliferative vitreoretinopathy; giant retinal tear; dislocated lens and intraocular lens; endophthalmitis; retinopathy of prematurity, diabetic retinopathy, vein occlusions and intraocular foreign body. Management of posterior segment diseases has undergone a sea of change with the introduction of vitrectomy. Many diseases considered inoperable have become amenable to treatment. Vitreoretinal surgeries are at less risk possibly, because of the high volume of the fluid that passes through the eye that may wash off the contaminants. Rhegmatogenous retinal detachment by definition is the separation of the neurosensory retina from the underlying retinal pigment epithelium caused by the presence of a retinal break. Although air was used in the management of retinal detachment as far back as 1911 by Ohm, it was Hilton and Grizzard who in 1984–85 popularized the technique of using gas to reattach selected cases of retinal detachment. Sharma and associates reported a series of 601 eyes that underwent primary scleral buckling by one surgeon. Proliferative vitreoretinopathy may be defined as a non-neoplastic growth and contraction of cellular membranes in the vitreous cavity and on both surfaces of the retina. Considering the unsatisfactory and unpredictable nature of the results, various innovations have been tried—some surgical and some pharmacological. Giant retinal tears are defined as retinal tears with circumferential extent of more than 90°. The success rate of reattachment with scleral buckling procedures was about 30%. This spectrum of diseases encompasses dislocation of whole crystalline lens, lens nucleus, lens fragments and intraocular lens. Endophthalmitis is a devastating condition of the eye with serious implications for the vision and the structure of the eye. Retinopathy of prematurity is the present accepted term for what was known as retrolental fibroplasias. Terry in 1942 first identified the disease as a cause of blindness in premature infants. The most common indication for vitreoretinal surgery happens to be the complications of diabetic retinopathy. Retinal vein occlusions could be broadly classified as central and branch occlusions. Ocular injuries can be broadly classified into open and closed globe variety.