The internal limiting membrane (ILM), composed of collagen fibers, glycosaminoglycans, laminin and fibronectin, is the basement membrane of the retinal Müller glia cells and serves as an interface between the vitreous and retina. The ILM is the structural interface between the vitreous and retina. ILM removal ensures separation of the posterior hyaloid from the macular surface, which can relieve macular traction and prevent postoperative epiretinal membrane formation. Thus, vitrectomy with ILM peeling has become an increasingly utilized and vital component in surgical intervention for various vitreoretinal disorders. However, many recent studies showed that ILM peeling is a procedure that can cause immediate traumatic effects and progressive modification on the underlying inner retinal layers.There were some surgical strategy (fovea-sparing ILM peeling or inverted internal limiting membrane flap technique, or Abrasion Technique). But some controversies exist, such as when ILM peeling is necessary, which adjuvant to use to perform the procedure, and what is the best technique to peel the ILM. A full assessment ILM structure and function and related factors of surgery is helpful to predict the anatomical and functional prognosis.