Central serous chorioretinopathy (CSCR) is one of the most common retinal causes of vision loss. This review surveys the epidemiology, risk factors, clinical presentation, natural history and pathophysiology of CSCR. Studies suggest an incidence rate of 10 per 100,000 in men, with CSCR occurring 6 times more commonly in men compared to women. Up to half of patients have a recurrent episode often within a year of the initial episode. The majority of acute CSCR cases resolve spontaneously within 2-3 months with visual acuity returning to close to premorbid levels. Prognosis is highly dependent on presenting visual acuity, with studies showing that patients with initial visual acuities of 6/6 remain at that level, while patients with initial visual acuities of less than 6/9 recover on average two to three Snellen lines over the next few years. The main risk factors for CSCR are systemic corticosteroid use, type A personality, pregnancy and endogenous Cushing's syndrome. Other risk factors which have been described include obstructive sleep apnoea, collagen vascular diseases, hypertension, elevated plasma testosterone levels and H.pylori infection. There are several presentations of CSCR including acute CSCR which presents clinically as serous neurosensory retinal detachment, recurrent CSCR with most episodes occurring within the first year, and chronic CSCR that persists beyond 6 months with distinctive retinal pigment epithelial changes and persistent shallow retinal detachments. The pathophysiology of CSCR remains obscure although disorders in both the choroidal circulation and retinal pigment epithelium are implicated. © 2012 The Authors. Clinical and Experimental Ophthalmology © 2012 Royal Australian and New Zealand College of Ophthalmologists.