Circumscribed choroidal hemangioma (CCH), a relatively rare benign tumor, can cause differential diagnostic problems by its atypical appearance at the time of presentation. Ancillary test such as fluorescein angiography, indocyanin green angiography, ultrasonography, computer tomography (CT), magnetic resonance imaging (MRI) bring not always additional information and their results are not always pathognomic. We retrospectively reviewed the clinical records of 40 patients with the ultrasonographical diagnosis of CCH compiled in the last 20 years. Ultrasonography appeared to be uniform in its lesion characteristics and reliable in the diagnosis. During the mean follow-up time of 7.4 years there were no clinical or posttherapeutical developments that made a correction of the diagnosis necessary.