Background and Objective: To compare the cost and utility of scleral buckle (SB) and pars plana vitrectomy (PPV) techniques for repairing moderately complex rhegmatogenous retinal detachment (RRD). Patients, Materials, and Methods: A cost-utility analysis was conducted using data from the Primary Retinal Detachment Outcomes Study (PRO) and a study conducted by the author. Total costs, patient utility over a lifetime, and cost per quality-adjusted life year (QALY) were calculated for each surgical procedure. Results: The cost of scleral buckle surgery was € 287.93, with an estimated lifetime QALY of 7.49. Costs per QALY were € 38.44. According to the PRO study and Belin et al, total costs were $5975, with a lifetime QALY of 5.4 and costs per QALY of $1106. The cost of pars plana vitrectomy (PPV) was € 1468.26, with an estimated lifetime QALY of 6.84 and costs per QALY of € 214.65. Based on the PRO study and Belin et al, total costs were $8125, with a lifetime QALY of 4.7 and costs per QALY of $2196. Conclusion: Repairing moderately complex RRD presents a highly cost-effective profile for both SB and PPV techniques, well below recommended QALY thresholds. SB demonstrated a slightly more favorable profile compared to PPV.