This paper presents a retrospective review of infectious agents associated with multifocal serpiginous choroiditis (MSC) based on polymerase chain reaction (PCR) evaluation and specific antimicrobial therapy. The study included 13 patients with MSC who were evaluated with PCR for the following organisms: mycobacterium tuberculosis (MTB), herpes simplex virus 1 (HSV1), Varizella zoster virus (VZV) and cytomegalus virus (CMV). Nine (69%) were positive for one or more organisms. Seven (54%) were positive for MTB, three (23%) for CMV. Nine patients completed six months follow-up and six resolved completely. Two continued to have lesions and one CMV positive required further additional valgancyclovir treatment. In this study the authors used multitarget PCR for MPB64 gene rather than the conventionally used multicopy element IS6110 because it gives better diagnostic yield. All but one of these patients showed complete resolution of inflammation following antiTB and steroid treatment. Tuberculosis (TB) remains the commonest and most important cause for MSC and PCR (of ocular fluid samples) can be a useful diagnostic tool. However, the role of HSV still remains to be established.