Since their introduction, retinal tacks have been increasingly used as an adjunct in the repair of complicated retinal detachments. Indications, results, and complications in a consecutive series of patients undergoing surgery for complicated retinal detachment are reported. Of the 47 patients with the potential for 6-month follow-up, 44 were available for evaluation. Overall complications were infrequent and usually controllable. At the 6-month follow-up interval, the macula was attached in 27 of the 44 patients (61%). Vision improved in 21 patients (48%). Between the intervals of 6 and 12 months, there was basic stability with two patients worsening in acuity, two patients improving, and 11 patients demonstrating no change. The use of retinal tacks appears to be a procedure with an acceptable complication rate which is helpful in repair of complex retinal detachments.