Abstract Purpose To clarify the long-term visual outcome of choroidal neovascularization (CNV) in eyes with high myopia in Asian patients. Design We reviewed the medical records of 25 consecutive patients (27 eyes) with myopic CNV who were followed up for at least 10 years after the onset of CNV. Visual acuity was examined 10 years after CNV onset. Intervention Demographic and clinical data were obtained from the patients’ medical records. Main outcome measures Visual acuity readings during the 10 years after CNV onset. Results At the onset of CNV, 19 eyes (70.4%) had a visual acuity better than 20/200, and six eyes (22.2%) had a visual acuity better than 20/40. Three years after the onset of CNV, 15 eyes (55.5%) retained a visual acuity of better than 20/200. At 5 and 10 years after the onset, however, visual acuity dropped to 20/200 or less in 24 eyes (88.9%) and in 26 eyes (96.3%), respectively. The logarithm of the minimum angle of resolution (logMAR) visual acuity was significantly worse at 5 and 10 years after onset as compared with that at CNV onset. Chorioretinal atrophy developed around the regressed CNV in 26 eyes (96.3%) at 5 and 10 years after the onset of CNV. Conclusions Long-term visual outcome of myopic CNV is extremely poor. The visual acuity of almost all of the patients dropped to 20/200 or less within 5 to 10 years after the onset of CNV, secondary to the development of chorioretinal atrophy around the regressed CNV. These findings indicate that active treatments should be recommended to prevent long-term visual impairment in Asian patients with myopic CNV.