Objective To compare the clinical effects of silicone removal by sutureless 23G pars plana surgery and routine 20G pars plana surgery. Methods One hundred and seventy-four consecutive patients (174 eyes) with rhegmatogenous retinal detachment undergoing single silicone removal were selected, and were divided into sutureless 23G pars plana surgery group (23G group, 79 eyes) and routine 20G pars plana surgery group (20G group, 95 eyes). The duration of surgery, visual acuity, intraocular pressure and complications after surgery were recorded and analysed. Results The mean duration of follow-up was (11.5±5.5) months (6 to 18 months). The mean duration of silicone removal in 23G group was (16.5±4.2) min, while that in 20G group was (35.2±7.4) min, and there were significant differences between two groups (P<0.01). There was no significant difference in best corrected visual acuity between two groups （P＞0.05）. Intraocular pressure in 23G group was significantly lower than that in 20G group 1 d and 3 d after surgery (P<0.05). The incidence of conjunctival inflammation in 23G group was significantly lower than that in 20G group (P<0.05) during follow-up. There was no significant difference in incidences of choroidal detachment, recurrent retinal detachment, vitreous opacity and vitreous hemorrhage between two groups after surgery (P＞0.05). Conclusion Compared with routine 20G pars plana surgery, silicone removal by sutureless 23G pars plana surgery is time-saving, with less complications after surgery, which may have definite prospects in clinical application.