Objectives: This study was designed to investigate the value of 3-D optical coherence tomography (3-D OCT) combined with fundus photochromy in the diagnosis of acute central serous chorioretinopathy (CSCR). Subjects and Methods: 3-D OCT and fundus photochromy were performed on 30 patients (36 eyes) with acute CSCR. Fluorescein angiography (FA) was also performed to confirm the diagnosis and to obtain the fluorescein leakage sites. Results: 22 eyes presented neurosensory retinal detachment determined by 3-D OCT (28 leakage spots), 1 eye showed retinal pigment epithelium (RPE) detachment (2 leakage spots), and 13 eyes showed both neurosensory and RPE detachment (17 leakage spots). 3-D OCT showed significant changes in the RPE in 36 of 47 leakage spots (76.6%). Fundus photochromy showed white-gray changes in 22 of the 47 leakage spots (59.6%). 47 leakage spots were identified by FA in 36 eyes. The combination of 3-D OCT and fundus photochromy identified 42 of the 47 leakage spots (89.4%) spotted by FA. Conclusion: A combination of 3-D OCT and fundus photochromy offered a high identification rate of the leakage spots. The combination of the two noninvasive techniques may be used as an alternative diagnostic or evaluation tool for acute CSCR.