Aims To determine the background incidence rate of retinal detachment (RD) in Western Australia (WA) between 2000 and 2013, identify sociodemographic features associated with increased risk of incident RD and examine trends in surgical repair technique. Methods A whole-population retrospective observational study of all people in WA was carried out using linked hospital inpatient records. Cases of RD were identified using a combination of International Classification of Diseases, Ninth revision, Clinical Modification (ICD-9-CM) and ICD-10-AM (Australian modification) diagnosis and procedure codes from routinely collected hospital inpatient data provided by the WA Data Linkage Branch. A Poisson regression model was used to examine the influence of age group, gender, season and year of surgery on RD incidence rates. Main outcome measures Age-standardised and sex-standardised incidence of first-eye RD and incidence rate ratio (IRR) of first-eye RD associated with age, sex and season. Counts of RD repair according to surgical technique. Results There were 4376 first-eye RD between 2000 and 2013. Age-standardised incidence ranged between 12.78 and 16.20 cases per 1 00 000 person-years. After adjusting for age, year and season, males had a higher risk than females for incident detachment (IRR 1.82, 95% CI (CI) 1.71 to 1.93), as did those aged 60-79 years (IRR 33.26, 95% CI 27.60 to 40.08) compared with those aged less than 20 years. RD repair with vitrectomy alone increased by 59% over the study period. Conclusion The incidence of first-eye RD remained stable between 2000 and 2013. The risk was higher in males and with older age.