Purpose: The purpose of this study was to determine the incidence of vascular events in patients treated with intraocular injections of bevacizumab. Methods: The subjects were 769 persons (mean age, 79.9 years; range, 47-97 years) from the Barnes Retina Institute in St. Louis. Patients received at least one intraocular injection of bevacizumab for the treatment of neovascular age-related macular degeneration. The study endpoints included myocardial infarction, cerebrovascular accident, thromboembolic disease, new hypertension, bleeding, and death. Results: There were events in 74 patients (9.6%; 95% confidence interval, 7.5-11.7%) over a mean follow-up of 13.2 months (range, 1-23 months). Among other events, 15 patients (2.0%; 95% confidence interval, 1-3%) had a nonlethal myocardial infarction, 27 patients (3.5%; 95% confidence interval, 2.2-4.8%) had an episode of new or increased blood pressure, and 19 patients (2.5%; 95% confidence interval, 1.4-3.6%) died. There was no correlation between the number of bevacizumab injections and incidence of any event. Conclusion: Intraocular bevacizumab may be safe for intraocular use from a systemic standpoint.