Purpose: To report a case of choroidal excavation accompanied by Vogt-Koyanagi-Harada disease (VKH). Methods: A 54-year-old Japanese woman who was complaining of bilateral blurring of vision associated with headache underwent optical coherence tomography (OCT), fluorescein angiography, and indocyanine green angiography as well as a routine ophthalmological examination. Results: Fundoscopy showed papilloedema and serous retinal detachment in both eyes. Fluorescein angiography detected bilateral multifocal leakage with pooling of dye in the subretinal space. Indocyanine green angiography showed patches of hyperfluorescence and hypofluorescent spots bilaterally. A diagnosis of VKH was reached soon afterwards. OCT of the left eye revealed the presence of a unilateral choroidal excavation under the fovea and subretinal fibrin over the site of the excavation. Treatment successfully resolved VKH symptoms with gradual resolution of subretinal fibrin and fluid; however, the choroidal excavation remained. Conclusions: This case is the first report of choroidal excavation associated with VKH. Our results suggest that choroidal excavation can be induced by choroidal inflammation caused by VKH.