The purpose of the study was to evaluate the effect of reduced-fluence photodynamic therapy (RFPDT) for chronic central serous chorioretinopathy (CSC) associated with serous retinal detachment (SRD) and fovea-involving pigment epithelial detachment (PED). Ten eyes of ten patients with chronic CSC associated with combined SRD and PED involving the fovea were included. RFPDT was applied to the hyperfluorescent area identified at the mid-to-late phase of indocyanine green angiography, which indicated the area of leakage. We evaluated the changes in best-corrected visual acuity (BCVA) and optical coherence tomography at month 1 and final follow-up visit. The mean age of the participants was 47.4 ± 7 years. The mean follow-up duration was 6.3 ± 4 months. At month 3, the SRD had resolved completely in all ten eyes (100 %), and PED had resolved in seven eyes (70 %). The initial mean BCVA improved from 20/50 at baseline to 20/32 at the last visit (P > 0.05). The mean central retinal thickness was reduced from 534 ± 279 µm at baseline to 194 ± 46 µm at the last examination (P < 0.001). The mean subfoveal choroidal thickness decreased from 461 ± 57 at baseline to 369 ± 75 at the final visit (P < 0.001). Reduced-fluence PDT appears as an effective treatment for chronic CSC cases associated with SRD and fovea-involving PED.