The combination of pars plana vitrectomy and scleral buckling surgery has been successfully used to repair rhegmatogenous retinal detachments. While employing both techniques, the ophthalmologist is afforded the ability to treat and drain subretinal fluid via a pars plana approach, perform endolaser, peel fibrous membranes, relieve retinal traction, and close retinal breaks. Scleral buckling provides an external approach to produce functional closure of retinal breaks responsible for retinal detachment and to reduce changes of recurrent detachment. Various options as far as segmental elements, encircling elements, and buckles made of different materials are available. Essential to all successful retinal detachment repair surgeries, all retinal breaks must be identified, and their extent delineated.