Over half a century has passed since the inception of vitrectomy, and the indications for its utilization in ophthalmology encompass the majority of vitreoretinal disorders. Technological advancements and equipment innovation have drastically reduced the surgical risk of vitrectomy, but some complications remain unavoidable. Occasionally, unexpected or unexplained visual impairments can manifest. Vitrectomy is associated with a high incidence of optic neuropathy, which can manifest weeks to months following the procedure and result in permanent visual impairment. An intraoperative optic nerve injury and a postoperative secondary injury comprise the causes. Intraocular pressure, dye toxicity, or mechanical damage can cause intraoperative optic nerve injury. Secondary injuries that occur after surgery include an increase in intraocular pressure, toxicity to silicone oil, oxidative stress, and other alterations in the microenvironment. This review will discuss the common causes, clinical manifestations, and related management of optic neuropathy connected to vitrectomy in order to attract the interest of ophthalmologists.