In this presentation from the 2012 Annual Meeting, Dr. Narsing Rao presents serpiginous choroiditis (SC), a posterior uveitis displaying a geographic pattern of choroidal changes typically extending from juxtapapillary choroid in a centrifugal pattern and a recurrent progressive choroiditis from margins of healed choroidal lesions. Limited histopathologic studies of eyes with SC revealed a chronic inflammatory process, and current ocular imaging studies support the inflammatory nature of SC with predominant involvement of inner choroid, choriocapillaris, retinal pigment epithelium (RPE), and outer retina. Although the etiology of SC is not clear, there are 3 likely inflammatory mechanisms. Therapeutic intervention studies suggest SC could be an autoimmune or idiopathic inflammatory process. Proper treatment depends on the clinician differentiating classic SC from mimicking conditions of infectious etiology.