Intravitreal pharmacotherapies have been used with increasing frequency in the treatment of retinal disease. Indications for their use include choroidal neovascular membranes, diabetic macular edema, ischemic neovascularization, inflammatory and infectious processes, and neoplasia. Complications of intravitreal therapies include cataract formation, glaucoma, and endophthalmitis. Recent developments of pharmacologic agents administered intravitreally and the new applications of systemic medications in retinal disease present the practitioner with expanded treatment options. Current and emerging data will help guide therapy in order to maximize the benefits and limit the systemic and ocular complications of these new treatment options.