AIM:To report 4 cases of acute and fundus obscuring,dense vitreous hemorrhage due to the formation of retinal hole.METHODS:Retrospective case study.The medical records of all patients were reviewed.RESULTS:Four patients included 2 male and 2 female with ages of 38 to 69 years old.The involved eye was the right eye(also high myopia)in one case and the left eye(myopia 1 case,emmetropia 2 cases)in 3 cases.The history of disease course was 1 day-3 weeks.The visual acuity was hand mouement-0.04 at initiate visit and improved in all cases following treatment of retinal hole by means of pars plana vitrectomy in 3 cases and laser photocoagulation alone in one case.The final vision was 0.04,0.2,0.6 and 0.8,respectively.CONCLUSION:We should be aware that acute vitreous hemorrhage can be induced by the formation of retinal hole.Early diagnosis and seal of the retinal hole can avoid retinal detachment and achieve better visual recovery.