Abstract: The peripapillary atrophy (PPA) is the atrophy of the retina and choroid adjacent to the optic disc. PPA is classified according to its clinical appearance into a central β zone and a peripheral α zone. According to the detailed anatomic figures revealed by SD-OCT, classic β zone PPA can further be divided into newly defined β zone PPA and newly defined γ zone PPA. The prevalence of PPA is related to the old age, the increase of intraocular pressure, the longer axis length and uveitis. Classic β zone PPA is a risk factor for the progression of glaucomatous neuropathy, the prevalence of myopic maculopathy and the worse prognosis of uveitis and Stargardt disease. The β zone PPA in SD-OCT is a risk factor for glaucomatous neuropathy, but its correlation with myopia is relatively weak. The γ zone PPA is related to the prolongation of the axis length, and it may be a protective factor for glaucomatous neuropathy. (Int Rev Ophthalmol, 2020, 44：  163-169)