The relationship between the presence of peripheral chorioretinal changes and axial myopia in 513 eyes (513 patients) 24 mm or more in length, or beyond the upper range of normal axial length, is studied. Axial length was measured with A-scan ultrasonography (immersion technique) and retinal periphery was studied by biomicroscopic examination and scleral indentation. The presence of lattice degeneration, pavingstone degeneration, pigmentary degeneration, white with or without pressure (WWP), retinal holes, tears, or both (RHT), retinal detachment, and posterior vitreous detachment was reported. The correlation between presence of a lesion and a longer axial length was always significant, except with retinal detachment, pigmentary degeneration, and RHT. Pavingstone degeneration was significantly related to older age and WWP and RHT to younger age. Posterior vitreous detachment was frequent in almost all axial length groups and age classes. No significant relationship was found between any kind of lesion and gender of the patient, or between axial length and patient age.