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This study investigated factors associated with chorioretinal atrophy (CRA) progression in myopic choroidal neovascularization (CNV) after anti–vascular endothelial growth factor therapy.Fifty eyes of 50 treatment-naive patients with myopic CNV who underwent anti–vascular endothelial growth factor monotherapy with at least 2 years of follow-up data were included. The cumulative occurrence of CRA progression was assessed using a Kaplan–Meier analysis. Demographic and clinical characteristics including macular choroidal thickness in various areas were compared between patients with and without CRA progression.The mean age was 52.34 years. A mean of 4.84 anti–vascular endothelial growth factor injections were performed over the mean follow-up duration of 44.6 months. Eventually, 15 eyes (30%) developed CRA progression. The estimated occurrence of CRA progression was 10% at 1 year, 19.1% at 2 years, 23.6% at 3 and 4 years, and 35.4% at 5 years. Chorioretinal atrophy progression was associated with a subfoveal CNV location (P = 0.029) and thinner subfoveal choroid in relation to the inferior choroid at 3 mm (P = 0.008). Visual improvement was only significant in eyes without CRA progression at 1 year, 2 years, and at the final visit.Chorioretinal atrophy progression was associated with a poor long-term prognosis. Relative thinning of the subfoveal choroid about the inferior choroid and subfoveal CNV location may predispose eyes with myopic CNV to develop CRA progression after anti–vascular endothelial growth factor therapy.