Background/Aim. Rhegmatogenous retinal detachment is a potentially blinding condition of the posterior segment of the eye. Currently, the only treatment modality is surgery and surgical options include scleral buckling, pars plana vitrectomy and pneumoretinopexy. Many factors may influence the outcome of the surgery. Well defined indications are essential for achieving the best postoperative results. The aim of this study was to assess anatomical and functional outcome of treatment with scleral buckling for macula- off rhegmatogenous retinal detachments. Methods. This prospective, nonrandomized, interventional study included consecutive patients underwent scleral buckling for macula-off retinal detachment in the tertiary centre for vitreoretinal surgery. Results. A total of 168 consecutive patients (mean age 58.2 ? 13.9 years) were included in the study. Postoperatively, anatomical success was achieved in 152 (90.5%) of the patients. Parameters that influenced the anatomical success included the number of retinal breaks (p = 0.040), lens status (p = 0.041), preoperative proliferative vitreoretinopathy (p < 0.001), patients? age (p = 0.049), and marginally, the presence of typical symptoms (p = 0.057). Duration of macular detachment, previous ocular trauma and refraction of the eye did not affect the anatomical result. Functional success was evaluated using the postoperative visual acuity and depended mainly on the duration of macular detachment prior the surgery. Visual acuity 0.4 or better was significantly more often achieved if duration of macular detachment was up to seven days (p < 0.001). Refraction and patients? age did not influence the functional result. Conclusion. Scleral buckling is an efficient surgical procedure for treatment of patients with retinal detachment. Optimal results are achieved if operation is performed within the first seven days of duration of macular detachment.