Objective: To analyze the effects of propofol and remifentanil combined closed-loop target controlled infusion on the depth of anesthesia and drug use in patients undergoing vitrectomy. Methods: 60 patients who underwent vitrectomy in our hospital from January 2023 to September 2024 were selected as the study objects. According to random number table method, the patients were divided into control group and study group, with 30 cases in each group. The control group was treated with conventional anesthesia. In the study group, propofol and remifentanil combined with closed loop target controlled infusion were used. Perioperative indexes (propofol dosage, remifentanil dosage, recovery time, orientation recovery time), mean arterial pressure (MAP) [before anesthesia (T0), at the beginning of surgery (T1), 30 minutes after surgery (T2) and after surgery (T3)] and the incidence of adverse events were analyzed and compared between the two groups. Results: The dosage of propofol, recovery time and orientation recovery time of the study group were significantly lower than those of the control group (P<0.05). There was no significant difference in the dosage of remifentanil between two groups (P>0.05). At T0, there was no significant difference in MAP between the two groups (P>0.05). At T1 and T2, the MAP of the two groups was significantly lower than that at T0 (P<0.05), and the MAP of the study group was significantly higher than that of the control group (P<0.05). At T3, the MAP of the control group was significantly lower than that at T0 (P<0.05), and the MAP of the research group was significantly higher than that of the control group (P<0.05). There was no significant difference in the incidence of adverse events between the two groups (P>0.05). Conclusion: The use of propofol and remifentanil closed-loop target controlled infusion in vitrectomy can reduce the dosage of anesthetic drugs and hemodynamic fluctuations, maintain the stability of anesthesia depth, and have high safety.