Pathological retinal neovascularization (RNV) is a common microvascular complication in several retinal diseases including retinopathy of prematurity, diabetic retinopathy, age-related macular degeneration and central vein occlusion. The current therapeutic modalities of RNV are invasive and although they may slow or halt the progression of the disease, they are unlikely to restore normal acuity. Therefore, there is an urgent need to develop treatment modalities that are less invasive and thus associated with fewer procedural complications and systemic side effects. This review article summarizes our understanding of the pathophysiology and current treatment of RNV in ischemic retinopathies, lists potential therapeutic targets and provides a framework for the development of future treatment modalities.