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Age-related macular degeneration (AMD) is the leading cause of severe, irreversible central vision loss in individuals over 65 years of age throughout much of the developed world. The advent of anti-VEGF therapy has had a great impact in the long-term natural history of this condition, more specifically in patients afflicted with exudative AMD. However, at the end-stages of the disease, therapeutic regimens such as anti-VEGF therapy and/or laser fail to achieve symptom resolution often leading to severe visual impairment and legal blindness. In selected cases, surgery has been advocated as a valid treatment modality in order to preserve vision. This review will evaluate the recent advances in surgical management of AMD, highlighting the different techniques that have been proposed and developed in the last 15 years. In addition, potential therapeutic strategies will be discussed and results obtained in clinical studies will be described.