Idiopathic central serous chorioretinopathy (ICSC) is a localized detachment of the sensory retina in the macula which is commonly seen by the general ophthalmologist. However, ICSC with bullous retinal detachment is a rare disease characterized by extensive sensory retinal detachment of the posterior pole and elsewhere. Thus far it has been reported in only nine Caucasian patients in the American literature. Two case reports are presented, one typifying ICSC, the other typifying ICSC with bullous retinal detachment. Although both entities probably share the same pathophysiologic mechanism, they are distinct in terms of diagnostic features and treatment. While ICSC is usually self-limiting and frequently diagnosed by history alone, ICSC with bullous retinal detachment is frequently misdiagnosed and subsequently treated improperly.