To measure the submacular choroidal thickness in eyes with idiopathic macular hole (IMH) compared with unaffected fellow eyes and normal control eyes.In this single institutional retrospective comparative case-control study, 34 consecutive patients with IMH were included and compared with 30 normal age- and sex-matched eyes that were planned to have cataract surgery. The included eyes were divided into 4 groups: 41 eyes with IMH (A), 23 unaffected fellow eyes (B), 30 normal eyes (C), and 12 vitrectomized IMH eyes (D).The choroidal thickness was significantly lower in all measured points in IMH eyes versus normal control eyes (subfoveal choroidal thickness [SFCT]: 215.76 ± 66.7 vs. 288.53 ± 72.0, P < 0.001) and at most locations in comparison between group B and C (SFCT: 231.79 ± 68.6 vs. 288.53 ± 72.0, P = 0.018). No significant difference was found in choroidal thickness between both eyes of patients with unilateral IMH (P = 0.81). The choroidal thickness was not altered after vitrectomy in the mean 6 months follow-up period. A negative correlation between the apical diameter and basal diameter of IMH and SFCT (P = 0.05) (P value of 0.034 and 0.05) and preoperative best-corrected visual acuity and apical and basal diameter of IMH (P = 0.006 and P = 0.029, respectively) was observed.Choroidal thickness is reduced in both eyes of patients with IMH compared with normal age- and sex-matched control eyes.