Experienced ophthalmologists who appropriately employ ancillary diagnostic testing, including fluorescein angiography, ocular ultrasonography, MRI, and fine needle aspiration biopsy, are remarkably accurate in the diagnosis of intraocular neoplasms. Recognizing the classic clinical features of the more commonly encountered lesions, such as choroidal melanoma, choroidal nevus, metastatic carcinoma to choroid, lymphoid tumors, and circumscribed choroidal hemangioma, and understanding the applicability and limitations of the various diagnostic tests are the keys to accurate detection.