During a four-year period, 53 of 92 eyes (58%) undergoing vitreoretinal surgery for a retinal detachment with proliferative vitreoretinopathy demonstrated anterior proliferative vitreoretinopathy. We classified anterior proliferative vitreoretinopathy according to tractional direction, location, extent, and severity. Initially, the eyes were treated with a high scleral buckle and laser endophotocoagulation as an adjunct to vitrectomy. Treatment then evolved into a direct approach in which the anterior proliferative tissue was surgically cut or excised. Of the 42 eyes followed up for at least six months, 25 (59%) were totally reattached and 18 (43%) had a visual acuity of 5/200 or better.