We highlight the difficulty in differentiating Coats' disease from retinoblastoma. Two patients with bullous exudative retinal detachment and abnormal vessels are discussed. Histologic evaluation of the 5-year-old patient revealed retinoblastoma. The 1-year-old patient had Coats' disease by histologic identification. With this in mind, we suggest enucleation of such eyes if diagnostic uncertainty exists, since failure to treat retinoblastoma is a more serious error than enucleation of an eye with minimal function.