Submacular hemorrhage is a vision-threatening complication of choroidal and retinal disease. Visual outcome after submacular hemorrhage is dependent on the underlying disease process, amount of subretinal hemorrhage, and duration before treatment. Treatment options include observation, surgical evacuation with or without tissue plasminogen activator (tPA), or pneumatic displacement with or without tPA. The preoperative amount of subretinal hemorrhage may help dictate what treatment modality is chosen.