Objective <p>To compare the effectiveness and safety of three loading doses of bevacizumab and ranibizumab for macular edema (ME) due to branch retinal vein occlusion (BRVO).</p> Methods <p>This retrospective study included 49 patients with BRVO. The patients were divided into two groups: the bevacizumab-first group (<i>n</i> = 23) and the ranibizumab group (<i>n</i> = 26). Patients in the bevacizumab-first group were treated with three loading doses of bevacizumab followed by pro-re-nata (PRN) regimen of ranibizumab. Patients in the ranibizumab group received three loading doses of ranibizumab followed by PRN regimen of ranibizumab. Mean change in best corrected visual acuity (BCVA), central macular thickness (CMT) and the number of injections were evaluated.</p> Results <p>At the end of the follow-up period, the mean changes in BCVA and CMT were not significantly different in both treatment groups. The retreatment rate in the bevacizumab-first and ranibizumab groups after the initial three injections were 65.3% and 38.5%, respectively (<i>p</i> &lt; 0.001). The mean number of injections within the follow-up period was 4.9 (SD, 2.1) in the bevacizumab-first group and 3.9 (SD, 1.5) in the ranibizumab group. This difference was not statistically significant (<i>p</i> = 0.05).</p> Conclusion <p>The retreatment rate was lower in the ranibizumab group after the initial three injections. Therefore, bevacizumab may be considered a clinically effective alternative to ranibizumab for the initial three loading doses in patients with BRVO- related ME, particularly when cost is a limiting factor.</p>