Central serous chorioretinopathy(CSC), first reported in 1866, is now recognized as the fourth most common macular fluid leakage disease after age-related macular degeneration, diabetic macular edema, and retinal vein occlusion. Although self-limiting in most cases, chronic CSC can cause the outer retinal atrophy and choroidal neovascularization, resulting in serious visual impairment. CSC used to be classified as a macular disease, or an acquired disease involving the macula. Thanks to the rapid development and application of fundus imaging technology, this concept has changed. Since 2013, CSC has been listed as choroidal vessel/Bruch's membrane disease, or choroidal disease, in the authoritative retinal books. CSC now belongs to a common phenotype of pachychoroidal diseases. The pathogenesis of CSC lies in choroidal vessel dilation, venostasis, remodeling and anastomosis between vortex veins, resulting in increased venous pressure and damage in choroidal capillaries, retinal pigment epithelium and outer blood retinal barrier, and then macular fluid leakage. However, the risk factors or causes of choroidal vessel abnormalities have not been elucidated. Current intervention strategies focus on eliminating macular fluid, and there is no effective treatment for eliminating etiology or risk factors. Therefore, the pathophysiology and etiological treatment of CSC deserve more attention.