Acute retinal pigment epitheliitis is an infrequently described macular disorder of unknown cause that affects healthy young adults. Acute symptoms include either reduced visual acuity or central scotoma. Ophthalmoscopy discloses discrete pigment clumps with surrounding hypopigmented halos in the center of the macula. Inflammatory signs are mild or absent. The hypopigmented areas show transmission hyperfluorescence without leakage on fluorescein angiography. Symptoms subside spontaneously although retinal pigment epithelial (RPE) changes are usually permanent. Central serous choroidopathy, macular edema, or permanently decreased vision have not developed in any of the eight patients we have followed for up to 8 years. Accurate identification of retinal pigment epitheliitis as a specific clinical entity is important because of the good prognosis without treatment.