The aim of this study was to compare the real-life outcomes of Intravitreal Ranibizumab (IVR) and Intravitreal Dexamethasone Implant (IDI) treatments in patients with Macular Edema (ME) secondary to Ischemic Retinal Vein Occlusion (IRVO). Methods: Retrospective, interventional case control study. The treatment naïve IRVO patients with ME who were treated with Intravitreal Ranibizumab (IVR) or Intravitreal Dexamethasone Implant (IDI) and had a minimum follow-up time of 12 months were included. Primary outcome measure was the change in Best Corrected Visual Acuity (BCVA). Secondary outcome measures were change in central retinal thickness and mean number of injections. Results: A total of 41 eyes of 41 patients were included. Nineteen patients (46.3%) were treated with IVR, 22 patients (53.7%) were treated with IDI. Mean BCVA in IVR group at baseline and month 12 was 1.25 ± 0.58 and 0.82 ± 0.54 LogMAR, respectively. Mean BCVA in IDI group at baseline and month 12 was 1.15 ± 0.52 and 1.09 ± 0.54 LogMAR, respectively. The change in mean BCVA was significantly better in IVR group than IDI group at month 12 (p = 0.05 for month 3, p = 0.1 for month 6, p = 0.07 for month 9, and p = 0.03 for month 12, respectively). Mean number of visits during the first year was 5.0 ± 1.0 (range 2-6) in IVR group, and 4.0 ± 0.9 (range 3-6) in IDI group (p = 0.004). Mean number of injections was 3.7 ± 1.2 (range 3-6) in IVR group, and 1.50 ± 0.6 (range 1-3) in IDI group (p < 0.0001). Conclusion: There was a statistically significant difference in regard to change in VA at month 12 between IVR and IDI treatments and the in-group VA changes was statistically better in IVR group which might suggest that IVR might be a better option in ME secondary to IRVO.