<i>Purpose:</i> Neovascular age-related macular degeneration (AMD) is a leading cause of blindness, with an increasing incidence as the elderly population expands. Large, multi-center, randomized, clinical trials have been conducted exploring the safety and efficacy of anti-VEGF treatments. This paper aims to discuss the safety and efficacy of pegaptanib, ranibizumab, aflibercept and bevacizumab. New therapeutic agents and treatment strategies are also discussed. <i>Procedures:</i> Evidence available from prospective, multicenter, clinical studies and from a selective literature search is utilized to present the results of VEGF inhibition in neovascular AMD and to generate evidence-based recommendations. <i>Results:</i> Anti-VEGF treatment is indicated in choroidal neovascularization with active disease and produces a significant benefit in visual acuity. <i>Conclusions:</i> With the advent of anti-VEGF therapy, the prognosis of choroidal neovascularization has changed dramatically. Data from well-conducted clinical trials suggest that approved anti-VEGF drugs are effective and well tolerated.