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Background and Importance Chronic central serous chorioretinopathy (cCSC) is a retinal disorder that can lead to persistent subretinal fluid, retinal pigment epithelium alterations, and progressive visual impairment. Off-label photodynamic therapy (PDT) with verteporfin has emerged as a potential treatment for refractory cases, but evidence on its real-world effectiveness remains limited.Aim and Objectives To evaluate the effectiveness and safety of off-label verteporfin PDT in patients with cCSC treated in a tertiary university hospital.Material and Methods A retrospective observational study was conducted among patients with cCSC who received verteporfin PDT (3 mg/m 2) between January 2021 and March 2024. Demographic variables (age, sex) and clinical parameters (best-corrected visual acuity (BCVA), neurosensory retinal detachment (NRD), pigment epithelium detachment (PED), and subretinal fluid (SRF)) were collected. Clinical outcomes were assessed using optical coherence tomography (OCT), fundus examination, and BCVA (decimal scale) at baseline and 2 months post-PDT. Safety was evaluated by the occurrence of adverse reactions (ARs).Results A total of 50 eyes from 41 patients (71% men, average age 58 ± 11.6 years) were analysed. Median BCVA improved from 0.5 (IQR 0.2–0.7) at baseline to 0.65 (IQR 0.3–0.9) at follow-up (Wilcoxon signed-rank test, p <0,001), indicating a significant improvement in visual acuity. After verteporfin PDT, BCVA improved in 56.0% (n = 28; 95% CI: 42.3%–68.8%) of eyes, while 44.0% (n = 22; 95% CI: 31.2%–57.7%) remained without clinical change. Of the 27 eyes with baseline NRD, 70.4% (n = 19; 95% CI: 51.3%–84.2%) showed improvement, and 29.6% (n =8; 95% CI: 15.8%–48.7%) remained unchanged. Of the 13 eyes with PED, 69.2% (n = 9; 95% CI: 42.0%–87.4%) showed improvement. Of the 21 eyes with SRF, 71.4% (n = 15; 95% CI: 49.7%–86.3%) achieved fluid reduction following verteporfin PDT. ARs occurred in three patients (6%), with secondary choroidal neovascularisation.Conclusion and Relevance Off-label verteporfin PDT demonstrated statistically significant effectiveness in patients with cCSC, leading to significant improvements in BCVA and anatomical outcomes. A majority of eyes with neurosensory retinal detachment, pigment epithelium detachment, or subretinal fluid showed clinical improvement, with few reported ARs and good tolerability. These results support verteporfin PDT as a valuable therapeutic option to stabilise and improve vision in patients with cCSC.Conflict of Interest No conflict of interest