Myopia is a global public problem that causes visual impairment. Its occurrence and development are often accompanied by changes in the various structures of the eye, especially pathological myopia, which involves degenerative changes in the sclera, choroid, and retina. In recent years, with the increasing prevalence of myopia, the exploration of pathological mechanism and the prevention and treatment of myopia have become an important issue that cannot be ignored in the world. The occurrence and development of myopia involves the participation of many factors and can cause serious visual damage. As an important vascular tissue in the eye, the thickness change of choroid has been proved to play a vital role in the occurrence and development of myopia. In order to comprehensively and effectively prevent and control the occurrence and development of myopia, especially high myopia, the change of myopic choroidal thickness and its related mechanisms should be one of the main directions of the pathological mechanism of myopia. This article reviews the research of changes of myopia choroidal thickness by domestic and foreign scholars in recent years, to discuss the relationship between choroidal thickness, choroidal vasculature, choroidal molecular changes and myopia, myopia-related complications, and myopia-related visual impairment. Provide new ideas on prevention and intervention of myopia.