BACKGROUND Acute retinal necrosis (ARN) syndrome is an uncommon but severe ocular disease that typically affects otherwise healthy individuals. It is frequently complicated with retinal detachment and the visual prognosis in such patients is usually poor. METHODS We operated on four eyes in four patients from 1999 through 2001. Three ophthalmologists in our hospital did these operations, respectively. The surgical methods included pars plana vitrectomy, lensectomy, encircling scleral buckling combined with membrane dissection, air-fluid exchange, endolaser photocoagulation, and retinal tamponade with silicone oil or perfluoropropane gas. RESULTS Three patients received one operation and the other one needed a second operation to release the retinal traction. One patient needed a lensectomy at the time of vitrectomy. Macular attachment was achieved in all four eyes (100%). Vision improved in two patients but none achieved visual acuity better than 20/200. The complications were cataract in three patients, macular pucker in three, and silicone keratopathy in one. CONCLUSIONS Our results suggest that modern vitrectomy techniques provide a very high retinal attachment rate in patients with retinal detachment following ARN syndrome.