Primary vitrectomy has emerged as a valuable surgical option for managing complex vitreoretinal disorders, particularly rhegmatogenous retinal detachment (RRD). Traditionally, scleral buckling was considered the gold standard for uncomplicated detachments, while vitrectomy was reserved for advanced cases. However, technological improvements in small-gauge instrumentation, wide-angle visualization, and fluidics have expanded its role as a primary intervention. Primary vitrectomy allows direct removal of vitreous traction, precise identification and treatment of retinal breaks, and efficient management of vitreous hemorrhage or proliferative vitreoretinopathy. Furthermore, it facilitates the use of internal tamponade agents, enhancing anatomical success rates. Multiple randomized and observational studies have compared vitrectomy with scleral buckling, demonstrating comparable or superior reattachment rates, especially in pseudophakic and complex detachments. Visual outcomes depend on factors such as macular involvement, preoperative duration of detachment, and presence of proliferative changes. While vitrectomy offers advantages of faster recovery, avoidance of refractive changes, and improved visualization, it is associated with risks including cataract progression, endophthalmitis, and elevated intraocular pressure. Careful patient selection remains critical, with scleral buckling still favored in younger, phakic patients with localized detachments and minimal vitreous traction. Overall, primary vitrectomy has redefined the surgical landscape of retinal detachment repair, offering a safe, effective, and versatile approach. Ongoing advances in instrumentation and tamponade strategies continue to refine its outcomes. Future research should focus on long-term visual function, quality of life, and cost-effectiveness to establish definitive guidelines for selecting the optimal primary procedure in different clinical scenarios.