To investigate the foveal morphological changes and foveal avascular zone (FAZ) area before and after epiretinal membrane (ERM) surgery. Twenty-two eyes with treatment-naive ERM were included in this retrospective study. The central foveal thickness (CFT) and FAZ area were measured via swept-source optical coherence tomography (SS-OCT) and OCT angiography pre- and postoperatively. The unaffected fellow eyes were used as controls. The preoperative superficial FAZ area was significantly smaller in patients (0.08±0.04 mm2) than in controls (0.33±0.09 mm2; P<0.001). The postoperative superficial FAZ (0.12±0.06 mm2) area was significantly greater than the preoperative area (P<0.001). The preoperative superficial FAZ area was strongly negatively correlated with CFT (P<0.001, rho=-0.763). ERM induced significant foveal morphological changes and reduction of the superficial FAZ area. Foveal thickness was restored and FAZ area increased postoperatively. However, the process is rather slow and the recovery is incomplete.