Purpose: To report the clinical course and management of a pediatric case of chronic rhegmatogenous retinal detachment (RRD) with a peripheral retinal break and concomitant full-thickness macular hole (FTMH) treated successfully with scleral buckling alone. Methods: A single case was retrospectively reviewed. Results: A 7-year-old boy with chronic RRD associated with a peripheral inferotemporal break and concomitant FTMH underwent scleral buckling. Postoperatively, the patient showed complete retinal reattachment, and optical coherence tomography revealed a progressive decrease in the size of the macular hole, with complete closure by postoperative month 4. The anatomic closure was associated with improvement in visual acuity. Conclusions: To our knowledge, this is the first reported case of pediatric RRD with a peripheral retinal break and concomitant FTMH in which scleral buckling alone resulted in both retinal reattachment and FTMH closure. This case highlights the importance of scleral buckling in selected pediatric RRD cases with concomitant FTMH, particularly when vitrectomy could be technically challenging.