Background Degenerative Vitreous Syndrome (DVS) is a well-documented, age-related condition characterized by vitreous liquefaction and collagen aggregation, leading to the development of symptomatic floaters that project shadows onto the retina and cause dynamic entoptic disturbances. Although Snellen visual acuity is typically preserved, an increasing body of evidence indicates that floaters, especially when central, can significantly impair functional vision. Despite this, DVS is often dismissed as benign and untreatable, even though OCT and ultrasound demonstrate posterior vitreous opacities. While observation and YAG vitreolysis are options, pars plana vitrectomy (PPV) is a definitive method for floater removal. Advances in small-gauge vitrectomy has resulted in improved safety profiles and shorter recovery times. Still, data on outcomes and patient satisfaction remains sparse. This study evaluates the safety, efficacy, and patient-reported results of small-gauge PPV for symptomatic DVS. Methods We conducted a retrospective case series involving 53 eyes treated with 25-gauge PPV by the same vitreoretinal surgeon. By design, the study focused on evaluating surgical outcomes in patients selected based on functional impairment attributable to vitreoretinal pathology. All procedures employed high-speed vitrectomy, triamcinolone-assisted vitreous visualization, complete posterior vitreous removal, and fluid-air exchange to optimize vitreous clearance and reduce residual collagen debris. Preoperative counseling emphasized the risks, benefits, and shared decision-making. Postoperative outcomes included anatomic assessments, complication tracking, and structured interviews regarding visual improvement and satisfaction. Results Among the 53 eyes treated, 91% (48/53) had preoperative posterior vitreous detachment (PVD), with the remainder undergoing intraoperative induction. Fifteen percent (8/53) of cases were combined with cataract extraction and intraocular lens implantation. No cases of retinal tear, detachment, endophthalmitis, or hypotony occurred. Postoperative epiretinal membranes (ERM) developed in 5.6% (3/53) of eyes, two of which required surgical peeling. Mean follow-up was 4.8 months. At final evaluation, 98.2% (52/53) of patients reported complete resolution of floaters; one patient noted a mild residual floater. Patient satisfaction was consistently high, with many describing restored “continuously clear vision” and expressing interest in surgery for the fellow eye. Conclusion Small-gauge vitrectomy is a safe and highly effective intervention for patients suffering from symptomatic floaters due to DVS. With careful surgical technique, patient-centered evaluation, and shared decision-making, PPV can offer dramatic improvements in visual function with minimal risk. These findings challenge traditional clinical reluctance to offer vitrectomy for floaters and underscore the need for more comprehensive assessment tools to better capture the true impact of DVS on patients and guide appropriate treatment options.