PURPOSE: To report the effectiveness and safety of intravitreal bevacizumab injection (IVB) compared with low-fluence photodynamic therapy (L-PDT) in eyes with chronic central serous chorioretinopathy (CSC). METHODS: This was a prospective comparative interventional study of 22 patients affected by chronic CSC. Patients were randomly assigned to group 1 (12 patients treated with 1.25 mg IVB) and group 2 (10 patients treated with L-PDT). In group 2, PDT with verteporfin was delivered at low fluence (300 mW/cm(2) for 83 s, 25 J/cm(2)). Follow-up visits were scheduled at 1, 3, 6, and 9 months. RESULTS: The improvement in visual acuity was greater in group 1 than in group 2, although the difference was not statistically significant (P = 0.59). The mean change in central point thickness over 9 months from baseline was 127 μm (SD 36) in group 1 and 114 μm (SD 42) in group 2. After the first injection, retreatments were given if recurrence was noted, with an average of 3.0 ± 1 injections in group 1 and 1.6 ± 0.6 treatments with L-PDT in group 2. The difference between retreatment in the 2 groups was not statistically significant (P = 0.45). CONCLUSIONS: Based on the results obtained after 9 months of follow-up, our study provides evidence that IVB may be a treatment option for chronic CSC.