Objective To observe the characteristics of spectral-domain optical coherence tomography (SD-OCT) for leakage point in acute central serous chorioretinopathy (CSC). Methods A total of 21 acute CSC patients (21 eyes) were enrolled in this retrospective study, including 17 men (17 eyes) and 4 women (5 eyes). The mean age was (47.3±8.8) years (range 35 - 66 years). The mean duration was (1.6±0.8) months (range 0.5 - 3.0 months). All patients were underwent mydriatic fundus photography, SD-OCT examination and fluorescein fundus angiography (FFA). SD-OCT and FFA images were carefully compared to observe the SD-OCT examination characteristics of fluorescence leakage point. Results 21/21 eyes had one fluorescein leakage point. In addition to serous retinal detachment, leakage point in the SD-OCT examination showed retinal pigment epithelium (RPE) protrusion in 10 eyes (47.6％), RPE detachment in 7 eyes (33.3％), highly reflective areas suggesting fibrinous exudate in the subretinal space in 3 eyes (14.3％), and RPE defect in 1 eye (4.8％). Conclusion The SD-OCT characteristics of acute CSC include RPE protrusion, RPE detachment, highly reflective areas suggesting fibrinous exudate in the subretinal space and RPE defect.