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Background and Importance Intravitreal injections of anti-vascular endothelial growth factor (anti-VEGF) agents, such as aflibercept and ranibizumab, are widely used. Although generally safe, they carry a risk of endophthalmitis, a rare but severe adverse event. Understanding its incidence is essential to enhance patient safety.Aim and Objectives To determine the incidence of endophthalmitis as an adverse reaction following intravitreal injection of prefilled syringe formulations of aflibercept and ranibizumab.Material and Methods A retrospective descriptive study was conducted including patients treated with aflibercept or ranibizumab between January 2021 and August 2025. They were identified using the hospital pharmacy dispensing software, filtered by indications: age-related macular degeneration (AMD), diabetic macular oedema (DMO), choroidal neovascularisation (CNV), retinal vein occlusion (RVO) and other eye diseases.Suspected cases of endophthalmitis were identified by searching for compounded ceftazidime and vancomycin eye drops or intravitreal syringes, both used in initial endophthalmitis management.Electronic medical records were reviewed to confirm the diagnosis and clinical courses.Results We identified 2019 patients treated with aflibercept and 1689 with ranibizumab. Among 101 patients who received compounded ceftazidime and vancomycin, 12 had previously been treated with anti-VEGF agents (2 aflibercept only, 4 ranibizumab only and 6 with both).6 confirmed cases of post-injection endophthalmitis were detected (4 women, 2 men), with a median age of 82.5 (55-94) years. Details of cases (case number, indication, anti-VEGF agent, onset of symptoms in days, previous injections of aflibercept/ranibizumab):CNV, aflibercept, 3, 9/2DMO, aflibercept, 5, 9/1RVO, ranibizumab, 7, 0/13AMD, aflibercept, 28, 10/6AMD, ranibizumab, 7, 0/6AMD, aflibercept, 7, 14/6Conclusion and Relevance Endophthalmitis represents a low-incidence adverse event associated with intravitreal anti-VEGF injections for AMD, DMO, CNV and RVO.No apparent differences were observed between aflibercept and ranibizumab regarding endophthalmitis occurrence. Ongoing pharmacovigilance and aseptic technique remain essential to ensure safe clinical practice.Conflict of Interest No conflict of interest