Purpose: The aim of our study was to evaluate the macular pigment optical density in patients with acute and chronic central serous chorioretinopathy and to describe the association between central retinal thickness and choroidal thickness with the macular pigment optical density. Materials and Methods: Eyes with acute central serous chorioretinopathy and chronic central serous chorioretinopathy (patients, who were diagnosed as having disease activity for 6 months) were included in this study. Macular pigment was measured using the heterochromatic flicker technique of the MPS II device for both eyes in patients with acute and chronic central serous chorioretinopathy and in control subjects. Results: Twenty-seven eyes with acute central serous chorioretinopathy, 23 eyes with chronic central serous chorioretinopathy, and 25 control eyes were enrolled. The mean macular pigment optical density in chronic central serous chorioretinopathy (0.480 ± 0.16 density unit (95% confidence interval: 0.390–0.570) was found to be significantly lower than in the control eyes (0.571 ± 0.128 density unit) (95% confidence interval: 0.480–0.670) ( p = 0.007). In correlation analysis, no significant association was detected between the central retinal thickness, choroidal thickness, and macular pigment optical density values in central serous chorioretinopathy group ( p = 0.31, p = 0.71). Conclusion: Macular pigment optical density levels were significantly lower in chronic central serous chorioretinopathy patients than in controls, possibly due to degeneration of the neurosensorial retina, as a result of the long-term persistence of subretinal fluid. There was not a significant correlation between choroidal thickness and macular pigment optical density levels in central serous chorioretinopathy group.