Eleven patients (13 eyes) with vitreous hemorrhage secondary to senile macular degeneration are reported. Two cases were bilateral. This unusual but not rare condition has a guarded visual prognosis, even with spontaneous clearing of the vitreous opacity, which occurred in about half of the eyes. Time required for resolution of the hemorrhage averaged 36 months. Diagnosis is based on the clinical setting and ultrasonographic findings. Senile macular degeneration should be considered as a possible cause of vitreous hemorrhage in elderly patients, especially those with macular changes in the opposite eye. Because of the limited expectation of visual improvement in patients with central macular lesions, vitrectomy should be done only in extraordinary circumstances.