AIM:To investigate the pathogenesis, clinical features and treatment of retinal vitreous hemorrhage . METHODS: Twenty-three eyes of spontaneous vitreous hemorrhage were collected, the reason of vitreous hemorrhage was the horse shoe-shaped retinal hole associated with vessel breaks 2 eyes were with the simple concurrent vitreous hemorrhage, 21 eyes were with rhegmatogenous retinal detachment complicated with vitreous hemorrhage; 3 eyes were performed only with laser treatment, 20 eyes underwent extra-retinal detachment surgery or vitrectomy.RESULTS: After laser or surgical treatment, there was no bleeding recurrence in the 23 eyes, hole was closed, the visual acuity of 22 eyes was better than or equal to that of preoperative, 1 eye of recurrent retinal detachment was the traction retinal detachment. CONCLUSION: Rhegmatogenous vitreous hemorrhage is a major reason for vitreous hemorrhage, early diagnosis and timely treatment can achieve a satisfactory effect and avoid serious complications.