A 37-year-old man developed geographic choroiditis and retinal vasculitis in the left eye while taking 3.5 mg/day oral prednisolone for rheumatoid arthritis. The choroidal lesions stopped growing when the dose of prednisolone was increased to 60 mg/day, while its tapering resulted in the recurrence and enlargement of the choroidal lesions to the macula. The patient experienced further recurrence twice in the following year. Indocyanine green angiography demonstrated the obstruction of choroidal arteries in addition to the complete obstruction of the choriocapillaris in a fresh lesion. This case was the first to have geographic choroiditis on the background of a systemic inflammatory disease.