The accurate diagnosis of central serous chorioretinopathy (CSC) and its distinction from differential diagnoses is crucial for effective patient counseling and treatment. This is achieved through a targeted patient history and multimodal imaging, which distinguish CSC from other ocular diseases also characterized by subretinal fluid and changes in the retinal pigment epithelium. In this article we identify the key differential diagnoses of CSC and illustrate the characteristic differential diagnostic features of each disease. The differential diagnoses of CSC can be categorized into eight groups: 1) (neo)vascular choroidal diseases, 2) retinal diseases, 3) inflammatory diseases of the posterior segment, 4) benign and malignant ocular tumors, 5) malignant hematological diseases, 6) genetic disorders, 7) ocular developmental anomalies and 8) medication-related and toxic retinal changes.