PURPOSE:: To evaluate the effect of syringe design and filling technique on the accuracy of anti-VEGF delivery. METHODS:: Volume output was measured with 3 syringe designs – a 1.0 mL slip-tip syringe, a 1.0 mL Luer-lock syringe and a ranibizumab pre-filled syringe – using two filling techniques (“upwards” and “downwards”) and two fluids – water and bevacizumab. A total of 300 simulated injections were performed. Accuracy was determined by difference from the intended volume of 50 µL and by mean absolute percentage error (MAPE). RESULTS:: Volume outputs were significantly different between syringe designs, with means of 61.99±4.18 µL with the 1 mL slip-tip syringe, 57.43±4.95 µL with the Luer-lock 1 mL syringe, and 51.06±4.74 µL with the ranibizumab syringe, making the latter the most accurate syringe. There were 37 (12.3%) cases of underdosing below 50 µL, the majority of which occurred with the ranibizumab syringe. The “downwards” technique reduced the occurrence of air bubbles. CONCLUSIONS:: Intravitreal injections using 1.0 mL syringes are less accurate than using the ranibizumab pre-filled syringe, which has a low volume and low dead-space plunger design. The variability in volume output may result in less predictable treatment response, especially in cases of underdosing, which were more common with the ranibizumab syringe.