Purpose: To evaluate the clinical features, primary anatomic success, visual outcome, and complications in patients with rhegmatogenous retinal detachment (RRD) undergoing scleral buckle surgery.Methods: A retrospective, cross-sectional, interventional study was conducted of 466 eyes with RRD that underwent scleral buckle surgery by a single surgeon at a tertiary care hospital in Pakistan.Results: The mean patient age was 40 ± 20 years with phakia (n = 367 [79%]). Total RRD (n = 222 [48%]) with mostly macula-off status (n = 443 [95%]) was present. Round hole (n = 270 [58%]) and single break (n = 258 [55%]) was common. Among the various types of buckles, the most commonly used was 42 band. The primary success rate of scleral buckle surgery was 84.1% in our study. The rate of detachment was found to be significantly decreased in the consecutive years from 2016 to 2020 (P < .001). The overall complication rate was 4.7% (n = 22), among which the most common complication was transient raised intraocular pressure (n = 11 [2%]). No significant difference was found in the primary attachment rate in phakic, pseudophakic, and aphakic lens status (P = .5) or for buckle configuration (P = .3). A significant difference was found among the type of buckle used (P < .05), with 506 sponge having the maximum attachment rate (n = 95 [93.1%]), followed by 42 band (n = 253 [82%]). There was significant improvement in mean visual acuity from 1.52 ± 0.4 logMAR preoperatively to 0.24 ± 0.10 logMAR postoperatively (P < .001).Conclusions: Our study indicates that scleral buckle surgery is a safe procedure for RRD and has a very good rate of success.