Immune dysfunction is a recurring theme in the pathogenesis of age-related macular degeneration, which is the leading cause of blindness in aged individuals. Understanding the dual nature of ocular immune pathways in both visual homeostasis and retinal damage could aid the development of immune-based therapeutics for this disease. Age-related macular degeneration (AMD) is a leading cause of blindness in aged individuals. Recent advances have highlighted the essential role of immune processes in the development, progression and treatment of AMD. In this Review we discuss recent discoveries related to the immunological aspects of AMD pathogenesis. We outline the diverse immune cell types, inflammatory activators and pathways that are involved. Finally, we discuss the future of inflammation-directed therapeutics to treat AMD in the growing aged population.