Persistent fetal vasculature (PFV) may present with a wide spectrum of ocular anomalies, including a retrolental plaque in a microphthalmic eye with prominent blood vessels on the iris and lens capsule with or without a stalk or persistent hyaloid artery. We demonstrate a technique to manage PFV with a substantial stalk in a child’s eye. Doppler ultrasound confirmed a lack of blood flow within the stalk; an anterior approach using the two-incision push-pull (TIPP) rrhexis for both the anterior and posterior capsulorrhexis was used. The posterior plaque was attached to a layer posterior to the posterior capsule, and these adhesions were carefully cut with the vitrector after cauterization of the stalk anterior face. Careful trimming of the stalk allowed it to recoil into the posterior vitreous cavity using anterior vitrectomy. Finally, the incisions were closed with 10-0 Vicryl.