Purpose To discuss different therapeutic approaches for retinal arterial macroaneurysm (RAM). Methods Educative video. Multimodal imaging is performed to evaluate the characteristics of RAM before and after distinct treatments. Results First, RAM complications such as exudation, macular edema, subretinal, intraretinal, sub-inner limiting membrane (ILM) and vitreous hemorrhage are presented being treated with diverse treatments. Second, the use of multimodal imaging in these cases through swept source optical coherence tomography angiography (SS-OCTA), fluorescein angiography and color fundus photography is highlighted. The role of SS-OCTA in the identification of RAM, determining its flow, is noted. Finally, the therapeutic tools, including anti-VEGF, corticosteroids, YAG laser hyaloidotomy, focal retinal laser, pars plana vitrectomy (PPV) with and without ILM peeling and pneumatic displacement with gas, are identified and detailed. Conclusions RAM requires miscellaneous treatments, from medical management to vitreoretinal surgery. Multimodal imaging based on OCT-A allows the analysis of RAM before and after treatment.