This large retrospective cohort study reviewed all patients who had bilateral intravitreal anti-vascular endothelial growth factor (VEGF) injections between April 2012 and August 2017. There were 101,932 procedures performed in 5890 patients. The two most common indications for injections were neovascular age-related macular degeneration and diabetic macular oedema. There were 28 cases of endophthalmitis (0.027% of total injections) during the study period. There were no cases of bilateral endophthalmitis; no individual patient had more than one episode of endophthalmitis. This study concludes that bilateral same day intravitreal injections are safe. Its rate of endophthalmitis is at the lower end of what is reported in the literature, however, there was no direct comparison with patients who had had unilateral injections from the same population. In addition, for a study that is retrospective using billing coding from clinics there is always the possibility that there were inaccuracies in the actual number of cases of endophthalmitis. Despite these limitations this study is the largest of its kind and reports reassuring results.