To report fundus autofluorescence (FAF) imaging findings of a patient with pigmented paravenous chorioretinal atrophy (PPCRA). In a patient with incidentaly detected bilateral PPCRA, FAF images were recorded with a new-generation confocal scanning laser ophthalmoscope (Heidelberg Retina Angiograph 2, Heidelberg, Germany). Atrophic areas typically appeared as hypoautofluorescent on FAF imaging, and borders of the chorioretinal atrophy areas appeared hyperautofluorescent, where RPE metabolism was presumably disturbed but chorioretinal atrophy has not yet appeared. It was remarkable that in some paravenous areas, hyperautofluorescence was seen where there were no evident abnormal findings in fundoscopy. PPCRA has a typical appearance by FAF imaging. FAF imaging may be a useful noninvasive tool in the recognition of the activity and predicting the progression of the disease.