Between September 1972 and March 1989, we examined 25 eyes of 24 patients exhibiting optic nerve-head pits associated with serous macular detachment. We followed 21 patients for a period of 1-15 years (mean, 62 months). Various treatment modalities were applied, depending on the time of initial examination. Five eyes underwent no treatment and three eyes underwent two distinct treatment modalities. Photocoagulation treatment was performed in ten eyes. Argon laser photocoagulation was combined with intravitreal injection of pure SF6 in eight eyes and of C3F8 in three. Intravitreal injection of pure C3F8 without photocoagulation was carried out in two eyes. The results of biomicroscopy of the vitreous gel and of fluorescein angiography and the responses to the various treatment modalities support the hypothesis that the mechanism underlying serous macular detachment complicating optic nerve-head pits is traction retinal detachment combined with a rhegmatogenous component in the roof of the optic pit.