Idiopathic macular hole(IMH)refers to full thickness defect of retinal neurepithelium layer in macular area with unclear reasons. Early IMH can be observed. Vitrectomy combined with internal limiting membrane(ILM)peeling is a conventional method for treating IMH. The continuous improvement and innovation of ILM surgery contribute greatly to the diversity and maturation of IMH treatment. At present, the pharmacological vitreolysis and pneumatic vitreplysis have gradual progress in the prevention and treatment of IMH. In this article we review the current management of IMH.