In conclusion, using a large dataset, we showed that MIVS does not increase the risk of endophthalmitis, despite recent concerns. Meticulous surgical asepsis, use of endotamponade, suturing of sclerotomy in doubtful cases and judicious use of antibiotics are crucial to minimize the risk of infection. Surgeons should be aware of the differences in presentation, microbiological profile, and factors responsible for unfavorable outcome. The outcomes are often guarded despite appropriate treatment. The risk of poor outcomes is potentially higher in culture-positive cases, which need to be treated aggressively.