Focal choroidal excavation (FCE) is a rare congenital or acquired anomaly characterized by a localized depression in the choroid, observed primarily on high-resolution imaging studies such as optical coherence tomography (OCT). This condition presents with a well-circumscribed depression in the choroid, without significant alteration of the overlying retinal layers. The retina may be conformal or non-conformal, depending on whether or not it is accompanied by the pigmented epithelium and choroid.