In a prospective study, limited choroidal hemorrhage (LCH) was found in 16 of 521 eyes (3.07%) subjected to cataract extraction. It developed in ten of 69 highly myopic eyes (14.49%), three of 64 moderately myopic eyes (4.49%), and three of 388 eyes without clinically significant myopia (0.77%). A positive correlation was found between LCH and vitreous loss in myopic eyes. A cause and effect relationship was not established. Of systemic factors investigated, an association was found between LCH and cardiovascular disease (14 of 16 cases). The ophthalmoscopic appearance and clinical findings support the hypothesis that LCH and expulsive choroidal hemorrhage are manifestations of the same disease processes and share common pathophysiologic mechanisms. The cause in any one case is probably multifactorial.