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To evaluate changes in peripapillary choroidal thickness in patients with branch retinal vein occlusion (BRVO) over 12 months, using spectral-domain optical coherence tomography with enhanced depth imaging.This retrospective, interventional case series included 20 treatment-naive patients with unilateral BRVO with at least 12 months follow-up. The peripapillary choroidal thickness was measured over 12 months.In BRVO-affected eyes, the mean peripapillary choroidal thickness was 213.5 ± 51.7 μm (126.1[FIGURE DASH]326.9 μm) at baseline and 129.6 ± 39.3 μm (65.9[FIGURE DASH]197.1 μm) at 12 months. In nonaffected contralateral eyes, the mean peripapillary choroidal thickness was 194.1 ± 39.8 μm (158.5[FIGURE DASH]238.3 μm) at baseline and 156.6 ± 56.2 μm (125.9[FIGURE DASH]213.9 μm) at 12 months. The mean peripapillary choroidal thickness decreased significantly over 12 months in both BRVO-affected and nonaffected eyes (P < 0.001, both eyes). Although the mean peripapillary choroidal thickness was not significantly different between groups at baseline (P = 0.472), it was significantly lower in BRVO-affected eyes than in nonaffected eyes at 12 months (P = 0.036).Peripapillary choroidal thickness decreased significantly over 12 months in BRVO-affected eyes and nonaffected eyes in patients with unilateral BRVO.