The Acute Posterior Multifocal Placoid Pigment Epitheliopathy (APMPPE) is a rare acquired idiopathic inflammatory disease that affects the choriocapillaris and external retinal layers. It usually presents as a bilateral, asymmetric, acute, visual loss in young healthy adults. The etiology of APMPPE is unknown and the pathogenesis is controversial, but it is thought that an obstructive vasculitis is the underlying disorder, causing non-perfusion of the retina layers. Funduscopic evaluation is characterized by multiple yellow-white lesions at the level of the retinal pigment epithelium (RPE) and choriocapillaris. Recently, noninvasive techniques of optical coherence tomography angiography (OCT-A) have provided a detailed three-dimensional analysis of blood flow in the retina’s layers and the inner choroid. To our knowledge there have been only a few reports describing OCT-A findings in APMPPE, so we describe a case that might contribute to the growing evidence of a primary choroidal involvement with secondary damage to the overlying RPE and the outer retinal layers, rather than a primary RPE inflammatory etiology, as was originally thought.