A series of 69 eyes in which silicone oil injection was used to treat retinal detachment with massive preretinal retraction was reviewed with respect to retinal re-attachment and visual function. The selection of patients for treatment with silicone oil injection was influenced by the poor prognosis with conventional methods, the high incidence of postoperative complications after silicone oil injection, and the prognosis of the fellow eye. Although silicone oil injection is not an ideal method of re-attaching the retina, it remains the only successful method in many cases of massive preretinal traction. In cases in which the fellow eye is defective or is at risk of becoming so, we believe that the injection of silicone oil is fully justified.