To assess spectral domain-optical coherence tomography (SD-OCT) contribution to choroidal osteoma characterisation.A retrospective chart review of a series of patients diagnosed with choroidal osteoma, which included patient, clinical, ultrasonographic, photographic and SD-OCT imaging.11 patients were included in this series. Their mean age was 42.5 years (median=43.0; range, 14-73). Using statistical analysis, the mean basal diameters of tumours as derived from fundus photographs (5.2 mm) and ultrasound images (6.4 mm) were significantly different (paired t-test, p=0.03). Tumours were SD-OCT hyporeflective in two cases, isoreflective in seven cases and hyper-reflective in two cases. Intrinsic reflectivity of the tumour was inhomogeneous in four cases. The overlying choroid was compressed by the tumour in eight cases and the retina exhibited degenerative changes in five cases.This study revealed that SD-OCT provided deeper and higher resolution images of choroidal osteoma when compared with previous studies using time domain-OCT. These findings offer new insights into the pathophysiology and diagnosis of choroidal osteoma.