Surgical treatment approaches can be classified as those used for acute and chronic endophthalmitis. Vitrectomy surgery is the basis of surgical treatment. According to the Endophthalmitis Vitrectomy Study findings, the most important criterion for performing surgery is the patient’s visual acuity. That study determined that a rapid decision of urgent vitrectomy was necessary for a favorable prognosis if vision is at the level of light perception. They reported that intravitreal antibiotics and close follow-up were more useful in individuals with visual acuity better than light perception. In the last 30 years since then, technological possibilities and capabilities in vitrectomy surgery have led to a shift toward performing surgery at an earlier stage, before visual acuity decreases to light perception. Currently, anatomical success rates exceed 90% when surgery is performed without delay in cases with decreased vision despite intravitreal antibiotic injection, worsening clinical course, corneal involvement interfering with intraoperative imaging, or a potentially fulminant pathogen.