Acute posterior multifocal placoid pigment epithellopathy is a chorioretinal inflammatory disease occurring in young, healthy adults. The long-term visual prognosis and recurrence rate is uncertain. We reexamined 28 patients (53 affected eyes) with acute posterior multifocal placoid pigment epitheliopathy (mean follow-up, 8 years) to obtain details on the long-term functional visual outcome. The final visual acuities were 20/25 or better in 48 eyes (90.6%), 20/30 to 20/100 in four eyes (7.5%), and 20/200 in one eye (1.9%). Although the final visual acuity was good, 33 eyes (62.3%) were symptomatic with blurred vision, metamorphopsia, or scotomas. Thirty-six eyes (67.9%) had significant central visual field defects on follow-up examination. There were no recurrences after the initial month of symptoms. The chorioretinal scars did not enlarge with time. Acute posterior multifocal placoid pigment epitheliopathy has a good longterm prognosis for visual acuity, although most patients have residual symptoms and paracentral scotomas.