The current management of acute post-operative endophthalmitis relies on microbial confirmation, intravitreal antibiotics, and vitrectomy. The endophthalmitis vitrectomy study (EVS) demonstrated that systemic antibiotics are not necessary in post-cataract/secondary intraocular lens (IOL) acute bacterial endophthalmitis, and that vitrectomy could be required only for eyes with presenting vision of light perception. Since the publication of the EVS newer tests are available for microbial confirmation, and many new and effective antibiotics are discovered for systemic therapy. We have studied large numbers of patients with endophthalmitis over several years. Perhaps our experience represents the endophthalmitis status in the developing countries. The article is a synthesis of recent publications in the world literature. Finally the authors have suggested a management strategy for acute post-cataract acute bacterial endophthalmitis.