To assess the merits of internal limiting membrane (ILM) peeling during pars plana vitrectomy (PPV) in subjects with a tractional retinal detachment (TRD) secondary to proliferative diabetic retinopathy (PDR). One hundred and ninety one PDR subjects undergoing PPV for the principal indication of TRD were enrolled into this randomized controlled trial. Study subjects were intraoperatively randomized into one of the following treatment groups: Cohort A patients underwent ILM peeling, while Cohort B patients did not undergo ILM peeling. The main outcome was postsurgical epiretinal membrane (ERM) development at 6 months. The secondary outcome was attainment of ≥ 20/50 visual acuity (Snellen) at 6 months. One hundred and thirty nine subjects underwent randomization and completed the study's 6-month trial period. Cohort A had 3.1% (2/64) of subjects develop an ERM postoperatively, while Group B had 26.7% (20/75) of subjects develop an ERM postoperatively at 6 months (p<0.001). Attainment of ≥ 20/50 visual acuity (Snellen) at 6 months was found in 21.9% (14/64) of subjects in Cohort A and 9.3% (7/75) of subjects in Cohort B (p=0.039). PDR patients undergoing PPV for TRD have a lower frequency of postsurgical ERM formation and a greater likelihood of attaining ≥ 20/50 Snellen visual acuity at 6 months when ILM peeling is conducted. Specialists may consider peeling of the ILM during PPV an important surgical maneuver in this patient population.