We compared the efficacy of an initial intravitreal aflibercept injection (IVA) followed by pro re nata (additional injection as needed) with that of intravitreal ranibizumab injection (IVR) for the treatment of naive patients with macular edema (ME) due to branch retinal vein occlusion (BRVO). Thirty- four consecutive patients (IVA group, n = 20; IVR group, n = 14) were reviewed retrospectively. A significant improvement in best-corrected visual acuity (BCVA) and reduction in central retinal thickness (CRT) from baseline at all time points was noted in both the groups but not between the groups. The rate of ME recurrence at 3 months was significantly smaller in the IVA group than in the IVR group, and the time between initial IV and the first ME recurrence was also significantly longer in the IVA group. In the early stages of ME caused by BRVO, aflibercept might have a sustained effect on ME suppression than ranibizumab.