Abstract: Objective To explore the clinical effectiveness of scleral buckling for rhegmatogenous retinal detachment (RRD) using a non-contact wide-angle viewing system combined with modified 25G fiberoptic endoillumination. Methods This is a retrospective cohort study. A total of 48 patients (48 eyes) with RRD who were admitted in Department of Ophthalmology, Xuzhou Municipal Hospital Affiliated to Xuzhou Medical University, from March 2022 to September 2023 were selected. According to the corresponding surgical methods used, the patients were divided into two groups: an endoillumination group (n=20, 20 eyes) and an indirect ophthalmoscope group (n=28, 28 eyes). Patients in the indirect ophthalmoscope group underwent traditional scleral buckling through binocular indirect ophthalmoscopy. In the endoillumination group, a self-made plastic sleeve was used to control a 25G optical fiber, which was inserted into the vitreous cavity to a depth of approximately 8 mm. A non-contact wide-angle viewing system was used to observe the fundus, and scleral buckling was completed. Then, both groups were compared for surgery time, success rate, and complications. Results The endoillumination group showed significantly shorter surgery time than the indirect ophthalmoscope group (P<0.001). The single-surgery reattachment rate was 96.4% in the indirect ophthalmoscope group and 100% in the endoillumination group, without statistical difference in surgical success rates between the two groups(P＞0.05). No intraoperative complications related to ocular surgery occurred in either group during the follow-up period. Conclusions Compared with traditional scleral buckling under an indirect ophthalmoscope, the use of a non-contact wide-angle viewing system combined with 25G fiberoptic endoillumination-assisted scleral buckling for RRD patients shortens surgery time, simplifies the procedures, but does not increase the recurrence rate of retinal detachment or surgery-related complications. This technique is worthy of clinical promotion.