Objective To observe the clinical efficacy of modified combination of initiative and passive minimally invasive silicone oil removal for eyes with silicone oil tamponade after rhegmatogenous retinal detachment surgery. Methods A prospective clinical study. The modified group, 33 eyes of 33 patients underwent initiative and passive silicone oil removal and the control group, 25 eyes of 25 cases received regular 23 G three channel silicone oil removal. The BCVA, intraocular pressure, surgery time, silicone oil residual and other complications were compared and analyzed. Results The difference of BCVA at any follow-up time were not statistically significant between before and after surgery of two groups (F=0.508, 0.360, P>0.05). The difference of BCVA were not significant between the two goups (t=-1.367, -1.258, -1.276, -1.434, P>0.05). The difference of intraocular pressure after surgery was not statistically significant between the two goups (t=-0.054, -0.895, 1.229, 1.092, P>0.05). The surgery time in modified group was shorter than that in regular group (t=-6.518, P=0.000). The rate of retinal redetachment was 3.03% in modified group and 4.00% in regualr group.The vitreous hemorrhage occurred in 1 case in regular group and no case in modified group. The difference of the rate of retinal redetachment and vitreous hemorrhage were not significant between two groups (χ2=0.040, 1.343, P=0.841, 0.246). Silicone oil droplets residual and endoophthalmitis were not found after surgery in both groups. Conclusion Modified combination of initiative and passive minimally invasive silicone oil removal is a safe, economical and effective surgical method. Key words: Silicone oil removal, minimally invasive; Retinal detachment; Effects, clinical