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We report a case of a young woman who presented with a vitreous haemorrhage associated with a combined hamartoma of the retina and retinal pigment epithelium (CHRRPE). During her clinical course, while the vitreous haemorrhage resolved, the lesion enlarged with a worsening epiretinal membrane. The patient’s visual acuity reduced from 0.06 to 0.4 logMAR (Snellen equivalent of 6/7.5 to 6/30) with worsening metamorphopsia over a 13-week period. She shortly underwent pars plana vitrectomy with a membrane peel with an improved anatomical and visual outcome.The case presented shows an uncommon presentation of CHRRPE in a patient with rapid clinical progression, highlighting the favourable outcomes of early surgery.