To describe the demographic, clinical and optical coherence tomography (OCT) characteristics of macular microholes and to determine if the size or character of the microholes has any correlation with vitreomacular interface abnormalities. Case records of 46 eyes of 39 consecutive patients with diagnosed macular microholes were reviewed as a non-interventional retrospective case study. Demographic and clinical features were noted from the detailed case records. Spectral domain OCT images were analysed for microhole and retinal characteristics. SPSS 16.0 was used for statistical analysis. Main outcome measure was the presence of vitreomacular interface abnormalities in large and small macular microholes. Of 39 patients, 21 were male and 18 were female. Most of these patients (56.4 %) presented with visual complaints. Clinically, the commonest feature was a 'red spot' at the fovea on indirect ophthalmoscopy (25 of 44 eyes; 54.3 %). Mean logMAR vision was 0.117 (±SD 0.21). 34 (76.08 %) eyes exhibited a photoreceptor loss, 38 eyes (82.6 %) had lamellar tissue defects involving layers posterior to the outer nuclear layer. The difference between means of the groups with and without vitreomacular interface abnormalities was analysed using the unpaired t test. The presence of vitreomacular interface abnormalities was significantly associated with the size of the microhole, with larger microholes being more likely to have vitreomacular interface abnormalities than smaller ones (p < 0.05). We concluded that there was a positive correlation between the size of the microhole and the presence of vitreomacular interface abnormalities. Visual acuity had no correlation with the size of the microhole; functional vision was generally well preserved in the affected eyes.