This study examined the effect of vitrectomy combined with internal limiting membrane (ILM) peeling on foveal displacement in 42 eyes with idiopathic macular hole (IMH). A retrospective analysis was conducted to measure various macular hole parameters before surgery, including basal diameter, minimum diameter, hole height, and areas affected by traction such as macular hole area (MHA), macular hole cystoid space area (MHCSA), macular hole retinal area (MHRA), and total area (TA). The results showed a postoperative shift of the fovea towards the optic disc in all cases. Notably, the extent of foveal displacement was significantly linked to the preoperative basal diameter (r = 0.405, P = 0.008) but not to other preoperative parameters or postoperative visual acuity. Furthermore, the study found that the temporal side of the macular hole was more affected by traction than the nasal side preoperatively, leading to greater postoperative displacement (All P < 0.05).