To present an uncommon case of coexistent rhegmatogenous retinal detachment and full-thickness macular hole, documented with Spectral Domain Optical Coherence Tomography, which closed after scieral buckling surgery. A 76-year-old woman presented with rhegmatogenous retinal detachment, with a primary peripheral tear. The coexistence of full-thickness macular hole was confirmed with Spectral Domain Optical Coherence Tomography. The best corrected visual acuity was counting fingers. Scleral buckling surgery with gas injection was performed. This single procedure not only resulted in retinal attachment but also enabled closure of the macular hole. After 14 weeks, the retina remained reattached and the Spectral Domain Optical Coheren- ce Tomography scans revealed closure of the macular hole. The final best corrected visual acuity improved to 0.5. Rhegmatogenous retinal detachment coexisting with a full-thickness macular hole is uncommon. This case demonstrates that in such rare situations it is worth beginning the treatment process with scleral buckling in order to close all peripheral tears. We may hypothesize that gliosis--the result of healing processes after retinal detachment--might have been the primary mechanism responsible for the idiopathic full-thickness macular hole closure in this particular case. Nevertheless, the actual mechanism still remains unknown.