Purpose: We present a case series of macula involving or non-involving rhegmatogenous retinal detachment successfully managed with pneumatic retinopexy with additional cryopexy and laserpexy as a primary single operation. Case summary: A review of two patients with visually significant macula off rhegmatogenous retinal detachment which involves more than 4 clock hours in expansion was conducted. At presentation, all two were underwent a pneumatic retinopexy with expansile Perfluoropropane pure gas 0.5 mL bubble with proper cryopexy and maintenance of appropriate head position regimen without intraoperative complications. The following day, laser was applied around the margin of the retinal break and intraocular pressure was monitored closely. During postoperative evaluation, the eyes achieved a good visual acuity and fundus examination revealed a fully resolved subretinal fluid and reattached retina. During short term follow-up, the retina remained completely attached and no further complications were detected. Conclusions: There is no significant drawback in trying pneumatic retinopexy primary in eyes that encounter the selection criteria. If a pneumatic retinopexy fails, a prompt following operation should be performed, the final anatomical and visual outcomes are not disadvantaged by the initial pneumatic procedure.