Optical coherence tomography angiography (OCTA) is a non-invasive imaging technique that visualizes retinal and choroidal vasculature by detecting blood flow without the need for contrast agents. However, image artifacts are common and can arise from various factors, including image acquisition, intrinsic ocular characteristics, eye motion, and image processing and display strategies. These artifacts can lead to misinterpretation of OCTA images, necessitating careful evaluation by clinicians. OCTA uses motion contrast to image blood flow, which is detected by analyzing changes in signal intensity or phase between successive scans. Artifacts such as projection artifacts occur when images of blood vessels appear at incorrect locations due to light passing through blood vessels and reflecting off underlying structures. Other artifacts include motion artifacts caused by eye movement, which can result in discontinuities in the displayed data. Image processing techniques can also introduce artifacts by altering vascular appearance or misrepresenting vessel density and location. OCTA has several advantages over traditional angiography methods, including the ability to generate three-dimensional datasets and visualize microvasculature without the need for contrast agents. However, it is susceptible to various artifacts, such as those caused by media opacities, which can reduce signal strength and affect the accuracy of flow detection. Additionally, the interpretation of OCTA images requires careful analysis, as artifacts can mimic true vascular changes. The challenge of imaging the living eye is significant, as the eye itself moves, making it difficult to distinguish between blood flow and eye motion. OCTA relies on detecting subtle changes in signal intensity or phase to identify blood flow, which can be affected by factors such as slow flow rates, which may not be detected due to sensitivity thresholds. The speed of OCTA imaging is also a critical factor, as faster imaging can reduce the likelihood of motion artifacts but may compromise image quality. Overall, OCTA is a powerful tool for visualizing retinal and choroidal vasculature, but its interpretation requires a thorough understanding of potential artifacts and their sources. Clinicians must be vigilant in evaluating OCTA images to avoid misinterpretation and ensure accurate diagnosis.Optical coherence tomography angiography (OCTA) is a non-invasive imaging technique that visualizes retinal and choroidal vasculature by detecting blood flow without the need for contrast agents. However, image artifacts are common and can arise from various factors, including image acquisition, intrinsic ocular characteristics, eye motion, and image processing and display strategies. These artifacts can lead to misinterpretation of OCTA images, necessitating careful evaluation by clinicians. OCTA uses motion contrast to image blood flow, which is detected by analyzing changes in signal intensity or phase between successive scans. Artifacts such as projection artifacts occur when images of blood vessels appear at incorrect locations due to light passing through blood vessels and reflecting off underlying structures. Other artifacts include motion artifacts caused by eye movement, which can result in discontinuities in the displayed data. Image processing techniques can also introduce artifacts by altering vascular appearance or misrepresenting vessel density and location. OCTA has several advantages over traditional angiography methods, including the ability to generate three-dimensional datasets and visualize microvasculature without the need for contrast agents. However, it is susceptible to various artifacts, such as those caused by media opacities, which can reduce signal strength and affect the accuracy of flow detection. Additionally, the interpretation of OCTA images requires careful analysis, as artifacts can mimic true vascular changes. The challenge of imaging the living eye is significant, as the eye itself moves, making it difficult to distinguish between blood flow and eye motion. OCTA relies on detecting subtle changes in signal intensity or phase to identify blood flow, which can be affected by factors such as slow flow rates, which may not be detected due to sensitivity thresholds. The speed of OCTA imaging is also a critical factor, as faster imaging can reduce the likelihood of motion artifacts but may compromise image quality. Overall, OCTA is a powerful tool for visualizing retinal and choroidal vasculature, but its interpretation requires a thorough understanding of potential artifacts and their sources. Clinicians must be vigilant in evaluating OCTA images to avoid misinterpretation and ensure accurate diagnosis.