Purpose: To evaluate the macular microvascularity with optical coherence tomography angiography (OCTA) in rhegmatogenous retinal detachment (RRD) which were successfully treated with pneumatic retinopexy (PR)., Methods: Thirty eyes of thirty patients who were treated with PR (12 eyes with macula-off RRD and 18 eyes with macula-on RRD) were included in this prospective study. OCTA was used to evaluate the macular perfusion changes postoperatively at 1 and 3 months. The fellow eyes (30 eyes) were used as control for comparison. Parafoveal retinal thickness (RT) and best-corrected visual acuity (BCVA) were evaluated., Results: Vessel density (VD) in SCP, DCP and choriocapillaris plexus (CCP) flow area was significantly lower in the macula-off group one month after the PR (p < 0.001). In the macula-off group, VD in SCP, DCP and CCP flow area significantly increased at months 3 (p < 0.001, p < 0.001, p = 0.009). The inner RT, RT and FAZ decreased three months after PR (p < 0.001, p = 0.001, <0.001). The FAZ was significantly larger in the macula-off group at third months after PR (p < 0.001). The inner RT was higher in the macula-off group at third month (p = 0.012). There was no significant difference between the groups in means of final VD, CCP flow area and RT. There was also a negative correlation between the final BCVA (logMAR) and FAZ at month 3 (r = 0.776, p = 0.003)., Conclusion: Optical coherence tomography angiography evaluation of macular capillary plexuses may be useful for predicting vascular structural changes in patients undergoing PR., (© 2020 Acta Ophthalmologica Scandinavica Foundation. Published by John Wiley & Sons Ltd.)