Background: Anatomical and surgical outcomes of macular hole surgery are influenced by multiple factors. These factors include the size and chronicity of the macular hole, use of biologic adjuvants, peeling of internal limiting membrane (ILM), the choice of intraocular tamponade and duration of postoperative positioning. Objective: To compare the effectiveness of pars plana vitrectomy (PPV) with either silicone oil or gas tamponade for the treatment of macular holes on visual and anatomical outcome. Patients and methods: This study included 10 eyes whom were operated on by  PPV with ILM peeling for repair of macular holes with either silicone oil tamponade (five patients) (50%) or sulfur hexafluoride (SF6) gas tamponade (five patients) (50%). The age of patients ranged from 24 to 72 years (mean 59 ± 14).  Female to male ratio was 6 to 4. Following up, the visual acuity and anatomical outcomes by Optical coherence tomography (OCT) have been done at 1 month and 6 months postoperatively. Results: The rate of hole closure after the primary operation showed a higher closure rate for gas-treated eyes 100% (5 of 5) than for silicone oil tamponade 80% (4 of 5). The final postoperative improvement in visual acuity for the gas group was better than for the oil group by 1 line in Early Treatment Diabetic Retinopathy Study (ETDRS) visual acuity chart. Conclusion: Gas tamponade was more successful in anatomical closure of macular holes than silicone oil tamponade. Eyes with macular holes surgically repaired with gas tamponade showed more improvement in visual acuity compared with eyes treated with silicone oil tamponade.