To report OCTA findings in 3 cases, 2 active and 1 inactive, of serpiginous choroidopathy (SC) and describe OCTA changes in response to treatment.Retrospective case series.We studied 6 eyes of 3 patients with SC.Retrospective case series of 3 patients with SC undergoing multimodal imaging, including OCTA. In 1 treated eye, both pre- and posttreatment images were compared.Description of OCTA findings in patients with SC.In the active phase, OCTA images show an apparent absence of the choriocapillaris with variable outer retinal and retinal pigment epithelial thickening. After treatment, OCTA of previously active lesions demonstrates a partial reappearance of the choriocapillaris, especially at lesion margins. In inactive SC, the choriocapillaris, along with the retinal pigment epithelium and outer retina, is notably absent.Optical coherence tomography angiography suggests absence of choriocapillaris in both active and inactive phases of SC with partial reestablishment following treatment. Although the exact pathogenesis of SC is not elucidated by these findings, OCTA images allow us to better evaluate choroidal involvement.