PURPOSE:: To quantify the rate of idiopathic-macular-holes (IMH) progression from presentation and identify factors that may influence stratification and urgency for surgical listing based on the initial Optical Coherence Tomography (OCT) scans. METHODS:: The Minimal-linear-diameter [MLD], basal-diameter [BD] and Hole-Height on nasal and temporal sides of IMH were measured on spectral-domain-OCTs, on initial presentation and just prior to surgery. Mean-Hole-Height, Hole-Height Asymmetry (HHA, absolute difference between Nasal-Temporal Height), MLD/BD and MLD change-per-day (MLD/day) were calculated for each patient. Multivariable linear regression analysis with MLD/day as the dependent variable were performed to identify significant risk factors for MLD progression. MLD were grouped to quintiles: 1:≤290, 2: >290 and ≤385, 3:>385 and ≤490, 4:>490 and ≤623 and 5:>623μm. RESULTS:: In 161 eyes (157 patients), we report significant associations with MLD/day: i) MLD/BD (p=0.039) [i.e. wide BD relative to MLD lead to faster progression of MLD], ii) HHA (p=0.006) [larger absolute difference between nasal and temporal hole height lead to faster progression], iii) days-between-scans (p<0.001) [longer duration between scans had reduced MLD/day, indicating more rapid increase initially then a plateaux], and relative to MLD-Quintile-1, ii) MLD-Quintile-3 (p=0002) and MLD-Quintile-4 (p=0008), MLD-Quintile-5 (p<0.001) all lead to reduced MLD/day rate on multivariable regression. CONCLUSIONS:: In addition to finding that the previously reported initial smaller MLD is a risk factor for rapid MLD progression, we report two novel findings, that large HHA and a low MLD/BD (wide base relative to MLD), represent significant risk factors. These factors should be taken into consideration on presentation, to stratify timing of surgery.