Context: Myopic macular hole retinal detachment (MMHRD) is difficult to treat due to its complex pathogenesis. The inverted internal limiting membrane (ILM) flap technique showed promising results in some studies. Aims: to evaluate the functional and anatomic outcomes of the inverted ILM flap technique in patients with MMHRD. Settings and Design:dareloyoun hospital, Cairo, Egypt, a retrospective interventional case series. Materials and Methods: we reviewed the records of eyes that underwent pars plana vitrectomy for MMHRD. They were divided into two groups; peel & invert group and peel & remove group, we evaluated macular hole closure, retinal reattachment and visual acuity.