To reveal the factors affecting the surgical outcomes and pathological findings in the fellow eye in patients who underwent pneumatic retinopexy (PR) for rhegmatogenous retinal detachment (RRD). Material and Methods: Patients treated for RRD between 2014 and 2021 were evaluated retrospectively. The study included 43 eyes of 18 female and 25 male patients who underwent PR. Age, gender, best-corrected visual acuity (BCVA), lens status, number of preoperative tears, macular involvement, tamponade, intraocular pressure, and anatomic success were evaluated preoperatively and at the last visit. The fellow eye findings were also investigated. Results: Retinal reattachment was observed in 21/43 (48%) eyes. Macular involvement was present in 24 (55.8%) patients. The mean BCVA before surgery was 1.4±1.2 logarithms of minimum angle resolution (logMAR), and the mean BCVA at the final follow-up after surgery was 0.8±0.9 logMAR (p=0.003). Macular involvement, gas type (sulfur hexafluoride-perfluoropropane), lens status (phakic-pseudophakic), and the location of the tear quadrant (2 o'clock/10 o'clock) were not determined to affect the surgical success (p=0. 43, p=0.37, p=0.15, p=0.73, respectively). Surgical success increased to 85% at the 1-year follow-up with secondary procedures. Lattice degeneration was found in 3 (7%) patients, retinal detachment in 4 (9%) patients, and retinal tear in 2 (4%) patients in the fellow eye of RRD. Conclusion: Although PR is a cost-effective method in RRD treatment, an additional surgical procedure may be required during follow-up. Detailed evaluation of the fellow eye pathologies is critical to prevent RRD development.