OBJECTIVE This study evaluated the results of photodynamic therapy (PDT) for polypoidal choroidal vasculopathy (PCV) 24 months or more after treatment. METHODS The study involved 47 eyes of 47 patients with PCV followed for 24 months or more after the first PDT. Fundus appearance, indocyanine green angiographic findings, and visual acuity (VA) were compared before PDT, and then at 3 months, 12 months, and the final visit after the first PDT. RESULTS At the final visit, VA was preserved or improved in 37 (79%) of the 47 eyes. Recurrence of polypoidal lesions was noted in 30 eyes (64%). An abnormal branching vascular network persisted in all subjects. In 26 of the 30 eyes exhibited recurrence of polypoidal lesions, which appeared in the periphery of the expanded abnormal branching vascular network. CONCLUSIONS Patients with PCV need to be followed for long periods of time after PDT because of the high incidence of polypoidal lesion recurrence. However, since polypoidal lesions often recur outside the fovea, and thus have little effect on VA, PDT can be expected to exert long-term efficacy in treating PCV.