Ocular venous air embolism(OVAE)is a rare and fatal complication in vitrectomy. Due to the proximity of the surgical site to the heart and its level above the heart, OVAE may be the most severe complication in the venous air embolism(VAE)caused by surgery. With the development of vitrectomy, perfusion cannulas in the suture-free state may slide outward, and the perfused gas can enter the suprachoroidal space, which results in tearing of the vortex veins. Choroidal vascular wounds resulting from trauma and endoresection of choroidal melanoma can expose directly in the perfused gas during vitreous cavity gas-liquid exchange. This makes it possible that the pressurized gas enters the circulatory system through the torn vortex veins or the anomalous choroidal venous openings, which leads to OVAE. Nowadays, the definition, pathogenesis, clinical presentation and prevention of OVAE are being refined. However, most vitreoretinal surgeons and anesthesiologists are still unaware of this iatrogenic complication. It will be helpful to detect this complication early and make emergency management in time by increasing the awareness of OVAE and develop effective prevention strategies. The prevention and control principles of OVAE can be continuously optimized by the combination of clinical and laboratory studies. It will be conducive to the establishment and improvement of emergency treatment and preventive measures of OVAE to fully understand the pathogenesis and clinical characteristics of OVAE, to pay attention to the characteristics of secondary lesions of OVAE, and to attach importance to multi-disciplinary cooperation.