Purpose: To investigate the effect of symptom duration in pseudophakic primary rhegmatogenous retinal detachment (RRD) with or without macular involvement on functional and anatomical outcome during first-year follow-up. Procedures: Retrospective review of cases with pars plana vitrectomy for retinal detachment repair. Symptom duration, functional outcome, and redetachment rates were analyzed. Symptom duration was grouped (1-3, 4-7, 8-14, 15-30, >30 days) and correlated to outcome in the first year of follow-up. Results: 371 macula-off and 230 macula-on RRDs could be included. In macula-off RRDs, longer symptom duration was associated with higher redetachment rates (10-21%; p = 0.032). Patients presenting symptoms for less than 8 days showed significantly lower rates than those with a longer symptom duration (p = 0.046). In macula-on RRDs, symptom duration and outcome were not associated (p > 0.6). Conclusions: In macula-off RRD, early reattachment surgery is necessary to lower the risk for retinal redetachment. The aim in macula-on RRD is to prevent conversion to a macula-off situation.