Intraocular metastases usually involve the posterior choroid. In women, there is usually a past history of breast cancer. In men, lung cancer is the most common primary malignancy, which is often detected only after the patient presents with the ocular disease. The intraocular metastases may be solitary or multiple, unilateral or bilateral. They are usually white or cream-colored, with overlying lipofuscin appearing as orange or dark-brown clumps, and serous retinal detachment. In addition to systemic workup, ocular investigations include color photography, autofluorescence imaging, ultrasonography, optical coherence tomography, and, in selected cases, biopsy. Treatment options include systemic therapy, various forms of radiotherapy, laser therapy, antiangiogenic therapy, and, rarely, local resection. Enucleation may be necessary if the eye is blind and painful. It is usually possible to save the eye with stabilization or improvement in vision. The systemic prognosis is usually poor, except for patients with carcinoid tumors. Patients with intraocular metastasis require holistic care, best provided by a multidisciplinary team.