<b><i>Aim:</i></b> To determine the efficacy of optical coherence tomography angiography (OCT-A) in diagnosing optic nerve head flow impairment in patients with optic nerve drusen. <b><i>Methods:</i></b> Patients affected by optic-nerve head drusen (ONHD) attending the Eye Clinic of the Federico II University of Naples were enrolled in this prospective case series between October 2015 and October 2016. Each patient underwent evaluation of best corrected visual acuity (BCVA), Goldman applanation tonometry, slit-lamp biomicroscopy, fundus examination, standard visual-field testing (perimetry), spectral domain (SD)-OCT and OCT-A. <b><i>Results:</i></b> Thirteen patients (6 females and 7 males with a mean age of 22.05 ± 7.54 years) with ONHD (19 eyes) were enrolled. Mean BCVA was 0.16 ± 0.21 LogMar and mean intraocular pressure was 15.68 ± 1.66 mm Hg. The control group constituted 16 individuals (24 eyes). Both ganglion cell complex (GCC) and retinal nerve fiber layer (RNFL) parameters were lower in patients than in controls. Similarly, the flow index (U = 134, <i>p</i> = 0.021) and vessel density (U = 90, <i>p</i> = 0.001) were significantly lower in eyes affected by ONHD than in normal eyes. Visual-field parameters did not differ between the 2 groups. GCC parameters were significantly correlated with OCT-A parameters (<i>p</i> < 0.05). No correlation was found between RNFL and OCT-A parameters. <b><i>Conclusions:</i></b> Our data suggest that OCT-A could be an objective method, helpful in the analysis of flow changes in patients with ONHD.