Aim: To determine the efficacy of internal limiting membrane (ILM) peeling vitrectomy for diffuse tractional diabetic macular oedema. Patients and methods:  A prospective non –randomized interventional study was carried out at Nour- EL–Hayaha Eye Center (Cairo) between March, 2015 and March, 2017. 40 eyes of 31 patients with symptomatic marked diminution of vision and tractional diabetic macular oedema were enrolled in this study. Ocular examinations included measurements of best corrected visual acuity (BCVA) at a distance using a logarithm of the minimum angle of resolution (logMAR) scale, refractive status using an autorefractometer (KR-8100; Topcon corporation, Tokyo, Japan), IOP  was measured by Goldman applanation tonometry (CT-80; Topcon corporation, Tokyo, Japan), and fundus evaluation using an indirect ophthalmoscope were obtained. 23-gauge vitrectomy with internal limiting membrane peeling assisted by staining by brilliant blue  G stain(BBG) were performed for all patients with a follow –up period at least 6 months. Spectral domain optical coherent tomography (SD OCT) images were obtained at the follow –up visits to determine the presence of an epiretinal membrane (ERM). Results: At 6 months there was a median 200µ decrease from baseline in the central subfield thickness (P<0.005).Mean change in the central subfield macular thickness was -150µ (SD± 130.56).There was 7 (17.5%) cases developed iatrogenic retinal break during removal of posterior vitreous and treated by endodiathermy, of greatest importance, 3(7.5%) eyes developed a vitreous hemorrhage treated by conservative treatment after B scan evaluation, and 1(2.5%) eye developed a retinal detachment. All complications were successfully managed. 23 out of 40 eyes (57.5%) underwent cataract surgery with IOL implantation within 6 months of pars plana vitrectomy. Transient elevation of IOP was developed in 7(17.5%) eyes and managed carefully with antiglucomatous drugs. One eye developed persistent elevation of IOP that required maintenance anti glaucomatous drug. Also macular hole developed in one eye and epiretinal membrane developed in one eye. Conclusion: ILM peeling achieved higher anatomic success with a reduced need for additional surgical interventions and or event postoperative ERM formation that might result in subsequent visual loss.