PURPOSE: To report a patient with antiphospholipid antibody syndrome (APS) presenting with ocular findings similar to serpiginous choroidopathy. METHODS: Case report. RESULTS: A man complained of blurred vision. Examination revealed vitritis, vasculitis, retinal ischemia, and neovascularization. Clinical and angiographic features consistent with serpiginous choroidopathy were found. An evaluation for uveitis and retinal vasculitis was remarkable for APS. CONCLUSION: This case expands on previously reported ocular findings associated with APS. Although the role of antiphospholipid antibodies in the pathogenesis remains undefined, the findings, including the serpiginous-like choroidopathy, can be reasonably explained by vaso-occlusion in both the retinal and choroidal vasculature.