Objective To observe the efficacy of localized vitrectomy at posterior pole and minimal C3F8 gas tamponade for the treatment of idiopathic macular hole. Methods The data of 40 eyes of 40 cases with idiopathic macular hole from Aug. 2013 to Jun. 2015 were collected and analyzed retrospectively. All cases underwent 25-gauge localized vitrectomy at posterior pole, internal limiting membrane peeling without staining and C3F8 gas tamponade (0.3-0.4 ml). After surgery all cases were required face-down position for 2 weeks. The visual acuity, intraocular pressure and macular structure was observed. Results No iatrogenic retinal tear occurred during surgery. After 6 months follow-up, the macular hole was closed in 37 eyes (92.50%), and visual acuity was improved in 35 eyes (87.50%). The average best corrected visual acuity (logMAR) after surgery was increased from 0.90±0.46 to 0.62±0.33, the difference was statistically significant (t=3.055, P=0.001). Conclusion The localized vitrectomy at posterior pole and minimal C3F8 gas tamponade is an effective method for idiopathic macular hole, with less traumatic and less time. Key words: Vitrectomy; Macular hole, idiopathic; Internal limiting membrane peeling; Tamponade, C3F8