Purpose <p>To investigate the morphological characteristics of dome-shaped macula (DSM) and inferior staphyloma complicated by serous retinal detachment (SRD).</p> Methods <p>Electronic medical records and multimodal images of patients diagnosed with DSM and inferior staphyloma were retrospectively reviewed. Morphological features, including axial length, curvature height, orientation of the dome, presence of retinal pigment epithelial detachment, choroidal vascular features such as subfoveal choroidal thickness, variations in choroidal thickness, presence of abrupt changes in choroidal thickness and presence of large choroidal vessels were analyzed.</p> Results <p>Fifty-three eyes of 37 patients were included, of which 33 eyes had DSM and 20 eyes had inferior staphyloma, and 15 (28.3%) were complicated with SRD. Four (12.1%) of the DSM and 11 (55.0%) of the inferior staphyloma eyes had SRD. On univariate analysis of risk factors for SRD, shorter axial length (<i>p</i> = 0.002), presence of inferior staphyloma (<i>p</i> = 0.004), higher subfoveal curve height (<i>p</i> = 0.009), thicker subfoveal choroidal thickness (<i>p</i> = 0.038), greater variation in choroidal thickness (<i>p</i> = 0.005), presence of both abrupt changes in choroidal thickness (<i>p</i> &lt; 0.001) and large choroidal vessels (<i>p</i> = 0.001) showed a significantly higher risk. On multivariate analysis, shorter axial length (<i>p</i> = 0.038) and presence of abrupt changes in choroidal thickness (<i>p</i> = 0.008) were identified as significant risk factors for SRD.</p> Conclusion <p>SRD was more prevalent in eyes with inferior staphyloma compared to DSM. Shorter axial length and abrupt changes in choroidal thickness were associated risk factors for SRD.</p>