The article describes a rare case of primary choroidal lymphoma with extraocular extension and bone marrow involvement in an 86-year-old man.[1][2] The patient had progressive loss of vision in the left eye over two years, with examination revealing yellow-white subretinal infiltrates and thickened choroid.[2] The diagnosis was confirmed by histopathological examination and immunocytochemical findings, which identified extranodal marginal B-cell lymphoma.[1][2] This case is the first in the literature to document primary choroidal lymphoma with bone marrow involvement, suggesting possible spread of choroidal lymphoma through the blood system.[1][2] Although primary choroidal lymphoma is usually low-grade and indolent, 78.6% of patients achieved complete remission with a median follow-up of 30.3 months with no reported lymphoma-related deaths.[1] The case highlights the need for clinicians to be aware of the possibility of choroidal lymphoma in patients with choroidal masses, especially when accompanied by extraocular extension.[1]