Myopic maculopathy is characterized by the presence of degenerative abnormalities of the central retina. We report the co-existence of a macular hole and atrophic choroidal neovascularization in a highly myopic patient. The occurrence of this association in the same eye without a history of intraocular surgery has been reported very rarely in the literature.OCT is a reliable diagnostic tool for a full thickness macular hole. When an atypical-appearing macular hole is detected, fluorescein angiography and OCT-A should be performed to detect associated choroidalneovascularization.The association described is of exceptional occurrence but with a serious prognosis and very limited chances of visual recovery.