PURPOSE: To describe clinical characteristics of serpiginous choroidopathy in the North Indian population.DESIGN: Retrospective cohort-based study.METHODS: Records of 86 patients who obtained a diagnosis of serpiginous choroidopathy at presentation or after a minimal follow-up of 2 years were retrieved. Group I included 62 patients who were diagnosed as having serpiginous choroidopathy at the initial presentation. Group II included 20 patients who initially presented as having multifocal placoid pigment epitheliopathy resembling acute posterior multifocal placoid pigment epitheliopathy (APMPPE) and had progressed over years to serpiginous choroidopathy, while group III had 4 patients with mixed presentations. Statistical analysis was done using the chi-square and Mann-Whitney U test. A review of the clinical, historical, fundus photographic, and fluorescein angiographic features was performed. The demographic and clinical features, number of recurrences, final visual acuity, and final description of healed lesions were documented.RESULTS: The median age at presentation was 30 years in group I, 29 years in group II, and 31 years in group III. The disease was bilateral in five (15%) patients in group I, 12 (60%) in group II, and all four in group III. All the affected eyes in groups II and III and 58 eyes (87%) in group I had recurrences over 2 to 8 years of follow up. Compared with group I, group II was characterized by more bilaterality (P = .001), less central foveal involvement (P = .001), better final visual acuity (P = .001), the presence of healed multifocal scars (P = .001), and less subretinal fibrosis (P = .02). Four patients in group III showed mixed features.CONCLUSIONS: Serpiginous choroidopathy in our population was seen in young patients and had three distinct presentations that seemed to affect the choriocapillaris primarily. Our patients appeared to have a variation of serpiginous choroidopathy, typical of the Asian-Indian population, that had some important differences from that reported in Caucasians.