We undertook a retrospective study of the files of 21 patients (42 affected eyes) with acute posterior multifocal placoid pigment epitheliopathy to obtain details on the natural history of the disease and on the functional and visual outcome (mean follow up: 17 months). The final visual acuities were 8/10 or better in 34 eyes (81.0%), 7/10 to 2/10 in 6 eyes (14.2%) and 1/10 in two eyes (4.8%). Although the final visual acuity was good in most eyes, 24 eyes (57.2%) were still symptomatic due to scotomas (33.3%), metamorphosia (21.4%), decreased vision (16.6%), floaters (4.8%) and chronic redness (2.4%). Recurrences did not occur in this group of patients. Electrophysiological and color vision tests were performed in the initial phase of the disease, but we found no correlation between the test results and the final visual acuity.