Angioid streaks (AS), initially identified by Doyne in 1889 in a patient with post-traumatic retinal hemorrhages, are linear lesions originating in Bruch’s membrane (BM) and may affect the retinal pigmented epithelium (RPE) and choriocapillaris. These streaks appear as dark red to brown lines and can lead to visual symptoms if they reach the fovea or cause complications, such as choroidal neovascularization (CNV) or retinal hemorrhages. Systemic associations are common, with pseudoxanthoma elasticum (PXE) being the most prevalent. AS are also linked with conditions like Paget’s disease and sickle cell anemia, among others. Diagnostic imaging, including fluorescein angiography (FA), optical coherence tomography (OCT), and indocyanine green angiography, helps identify subclinical changes. The introduction of antiangiogenic therapy (anti-VEGF) has significantly improved outcomes in patients with CNV secondary to AS. Although there is no targeted treatment for AS, early intervention for complications can reduce the risk of irreversible vision loss, underscoring the importance of regular monitoring, particularly given the high bilaterality and recurrence rate associated with CNV in these patients.