Use of 23-gauge technology provides numerous poten- tial advantages over traditional 20-gauge vitrectomy. Addition- ally, Triamcinolone acetate (TA) has been shown to facilitate fluid absorption from the edematous retinal tissue. Patients and Methods Retrospective, nonrandomized study of consecutive patients who underwent 23-gauge transconjunctival sutureless PPV with sub- sequent membrane peeling and intravitreal TA injection for an idiopathic epiretinal membrane (ERM) between February 2007 and February 2008. Results Thirty-nine eyes of 39 patients were included. The mean follow-up was 7 months (SD: 2.2). Mean pre- operative BCVA was 0.28 decimal equivalent (logMAR 0.54, SD: 0.2). and improved significantly (P <0.0001, 2-tailed t test) to a mean of 0.6 decimal equivalent (logMAR 0.22) at the final follow- up. The visual acuity improved by a mean of 3.2 lines (SD 2.1). Twenty-nine patients (74%) demonstrated a gain of 3 or more lines. Average central macular thickness reduction was 131μm (SD: 77) 84% of which occurred during the first week. Conclusions Moreover, 23-gauge sutureless PPV with the concomitant administration of intravitreal TA is a safe and effective technique for the treatment of idiopathic ERM and may speed up anatomical recovery.