Purpose: To evaluate the role of cryopexy in the stimulation of postoperative proliferative vitreoretinopathy (PVR) in primary rhegmatogenous retinal detachment. Materials and methods: A series of 595 eyes of 554 patients with primary rhegmatogenous retinal detachment, referred before any failed surgery, were prospectively evaluated. Univariate and multivariate statistical analyses of the data were conducted. Results: The incidence of postoperative PVR in relation to the methods used for retinopexy was dependent on the types and anatomy of retinal breaks associated with retinal detachment. The incidence of postoperative PVR was nil in retinal detachments due to atrophic holes in lattice, oral dialyses, and macular holes, regardless of the retinopexy methods. Postoperative PVR occurred solely in retinal detachments due to horse-shoe tears (incidence 4.42%), paravascular tears of the postequatorial region (18.18%), and giant tears (24.6%) (P<0.00001). the="" incidence="" of="" postoperative="" pvr="" was="" 0.5%="" in="" eyes="" with="" horseshoe="" tears="" with="" mobile="" posterior="" edges="" vs="" 9.72%="" in="" eyes="" with="" horseshoe="" tears="" with="" curled="" posterior="" edges,="" regardless="" of="" the="" retinopexy="" methods="">P<0.00001). in="" retinal="" detachments="" due="" to="" horseshoe="" tears="" with="" mobile="" posterior="" edges="" the="" incidence="" of="" postoperative="" pvr="" (0.5%)="" was="" not="" influenced="" by="" the="" retinopexy="" methods.="" in="" contrast,="" in="" retinal="" detachments="" due="" to="" horseshoe="" tears="" with="" curled="" posterior="" edges="" the="" incidence="" of="" postoperative="" pvr="" was="" higher="" in="" eyes="" managed="" with="" cryopexy="" (14.77%)="" than="" in="" eyes="" managed="" with="" laser="" retinopexy="" (1.78%)="">P<0.02). in="" retinal="" detachments="" due="" to="" giant="" tears="" the="" incidence="" of="" postoperative="" pvr="" was="" not="" statistically="" significantly="" greater="" in="" eyes="" managed="" with="" cryopexy="" (33.3%)="" than="" in="" eyes="" managed="" with="" laser="" retinopexy="" (15.6%).="" in="" tears="" 180°="" and="" over="" in="" size,="" however,="" the="" incidence="" of="" postoperative="" pvr="" was="" significantly="" higher="" in="" eyes="" managed="" with="" cryopexy="" (9/11="" eyes)="" than="" in="" eyes="" managed="" with="" laser="" retinopexy="" (5/17="" eyes)="">P=0.006). Conclusions: Cryopexy is not a stimulating factor for postoperative PVR in primary rhegmatogenous retinal detachments due to atrophic holes in lattice, oral dialyses, macular holes, or horseshoe tears with mobile posterior edges. In contrast, cryopexy probably is a stimulating factor for postoperative PVR in retinal detachments due to horse-shoe tears with curled posterior edges or to retinal tears 180° and over.