Idiopathic polypoidal choroidal vasculopathy was first described by Yanuzzi in 1982 in the Macula Society Meeting as a disease occurring in females of African-American origin characterized by hemorrhagic lesion of the macula. Other authors described this condition as posterior uveal bleeding syndrome. There are reports that PCV can present in other races as well. Polypoidal choroidal vasculopathy is an ill understood entity that mimics some of the features of age-related macular degeneration. It is characterized by visible orange choroidal polyps and can manifest as recurrent hemorrhages and sometimes massive serosanguineous retinal and RPE detachments. ICG angiography is important in the identification of the lesions, their activity and sometimes their pulsatile nature. Treatment revolves around photocoagulating the identifiable lesions with direct laser or PDT depending on the location. Treatment with anti-VEGF drugs has not been very successful. Although fibrosis in PCV is not as commonly seen as in age-related macular degeneration, the prognosis of the disease is variable and significant visual loss is not uncommon. PCV patients with massive hemorrhage have poor visual prognosis.