OBJECTIVE Persistent fetal vasculature (PFV) may be associated with tractional retinal detachment due to tractional contraction of the fibrovascular stalk. PFV is often thought to be congenital and non-progressive. A rhegmatogenous component is far less common and is typically identified as a post-operative complication and has not been spontaneously reported. We present five cases illustrating potential progressive changes and complications that may arise in non-operated PFV. METHODS A retrospective case series of five patients who presented with progressive retinal detachments from persistent fetal vasculature. RESULTS Five unique cases of persistent fetal vasculature with significant progression from time of initial presentation, four of which included development of rhegmatogenous components. CONCLUSIONS Patients with PFV and a seemingly stable tractional detachment should undergo evaluation with a retina specialist for risk stratification and management, as rhegmatogenous detachments may occur due to ocular growth and stretch breaks, and tractional detachments can continue to progress over time.