Myopic choroidal neovascularization is the leading cause of central vision loss in pathologically myopic patients. Its prevalence is particularly high in East Asia, and has continually increased in recent decades. Development of axial elongation-related mechanical stress, changes in choroidal blood circulation and induced inflammatory responses have been implicated in the pathogenesis of this disease. Common symptoms include decreased central vision, metamorphopsia, and central scotoma. Various ophthalmic devices, including fluorescein angiography, optical coherence tomography (OCT), and OCT angiography can be used to establish a diagnosis and develop an appropriate treatment plan. Intravitreal anti-vascular endothelial growth factor injection therapy is widely viewed as the current gold standard, with ranibizumab and aflibercept being the most widely used agents. However, unlike in other choroidal neovascular diseases, tracking disease activity in myopic choroidal neovascularization and recognizing when treatment is warranted remains difficult. Various studies have been attempted to establish imaging biomarkers to resolve these concerns. In this review article, we describe the latest data on myopic choroidal neovascularization, including the epidemiology, pathophysiology, and current trends in diagnosis and treatment.