The Collaborative Pneumatic Retinopexy Study evaluated retinal detachments (RDs) secondary to one break or group of breaks no larger than 1 clock hour located within the superior 8 clock hours of the fundus. Eyes with prominent proliferative vitreoretinopathy (PVR) were excluded. Forty eyes which exceed these criteria and were treated with pneumatic retinopexy have been retrospectively evaluated to determine what preoperative conditions limit the application of pneumatic retinopexy. Multiple breaks in multiple quadrants, large tears up to 2.5 clock hours in size, and RDs associated with a moderate degree of PVR were successfully managed with pneumatic retinopexy. The greatest number of failures were due to inferior breaks. The overall success rate for pneumatic retinopexy was 75%. New breaks occurred in 12.5% of eyes, but all of these were successfully managed.