Vitreoretinal surgery has come a long way since the introduction of pars plana approach by Robert Machemer. In the past five decades, it has developed into a major subspecialty with well-structured fellowship programs. The indications for vitreoretinal surgery have expanded to include many hitherto untreatable conditions. This chapter covers the relevant anatomy, history of evolution of vitreous instrumentation, instrumentation and fluidics in microincisional vitrectomy surgery, procedures, advantages of microincisional vitrectomy surgery, limitations of microincisional vitrectomy surgery, and problems with small gauge vitrectomy. The vitreous base and the vitreoretinal relationship are perhaps the most important anatomical issues that dictate several aspects of vitreoretinal disease and surgery.