AIM: To evaluate the efficacy of vitrectomy in combination with intravitreal dexamethasone and vancomycin perfusion in the management of severe posttraumatic endophthalmitis. · METHODS: Thirty eyes of 30 cases diagnosed as posttraumatic infectious endophthalmitis were analyzed retrospectively from April 2004 to April 2006. All the patients underwent vitrectomy in combination with intravitreal drugs perfusion and were followed up for 12 to 24 weeks. The visual acuity, traumatic causes and microorganisms culture were analyzed. · RESULTS: There are significant reduction in inflammation at 3 months after surgery. Infectious symptoms were completely controlled in 97% of the cases(29/30). Final visual acuity were improved in 93% of cases (28/30). Among traumatic causes, foreign body is the most common cause (57%). Staphylococcus aureus is the commonest microorganism. · CONCLUSION: Vitrectomy in combination with intravitreal dexamethasone and vancomycin perfusion is the most effective method in the treatment of severe posttraumatic endophthalmitis.