The use of vitrectomy in the management of endophthalmitis is controversial. All cases of suspected clinical endophthalmitis should have immediate anterior chamber and vitreous aspiration combined with an intravitreal antibiotic/steroid injection. Vigorous systemic, topical and periocular therapy should accompany frequent examinations of the patient. Vitrectomy is recommended in selected clinical situations. An intraocular lens usually can be left in place and should be removed only in certain rare instances.