Purpose <p>To evaluate the long-term visual outcomes of patients with neovascular age-related macular degeneration (AMD) who were lost to follow-up (LTFU) during treatment compared with those with continuous follow-up (CFU).</p> Methods <p>A retrospective study was conducted on patients diagnosed with neovascular AMD who received anti-VEGF therapy from 2010 to 2022. The patients were classified into the long-term LTFU group (LTFU for more than 6&#xa0;months), the short-term LTFU group (LTFU for 2&#xa0;months to less than 6&#xa0;months), and the CFU group. We conducted a comparative analysis of baseline characteristics, factors related to visual prognosis, and differences in the occurrence of severe vision loss.</p> Results <p>A total of 169 patients were classified into 43 in the long-term LTFU group, 57 in the short-term LTFU group, and 69 in the CFU group. The mean follow-up duration was 57.12 ± 31.68&#xa0;months. There was no significant difference in baseline visual acuity (logMAR) among the long-term LTFU, short-term LTFU, and CFU groups (0.76 ± 0.54, 0.68 ± 0.51, and 0.72 ± 0.54, respectively; <i>P</i> = 0.734). The final visual acuity was significantly lower in the long-term LTFU group (1.12 ± 0.79) compared with the short-term LTFU group (0.65 ± 0.62) and the CFU group (0.65 ± 0.56) (<i>P</i> &lt; 0.001), and the change in visual acuity was significantly greater in the long-term LTFU group (0.36 ± 0.69) compared with the short-term LTFU group (-0.03 ± 0.64) and the CFU group (-0.07 ± 0.58) (<i>P</i> = 0.001). Long-term LTFU was significantly associated with changes in visual acuity from the baseline to the final visit (<i>P</i> = 0.002) and severe vision loss (<i>P</i> = 0.002).</p> Conclusion <p>In patients with neovascular AMD, those LTFU for more than six months during treatment had worse long-term visual outcomes compared to those with regular follow-up or shorter LTFU durations.</p>