BACKGROUND AND OBJECTIVES: To compare chorio-capillaris perfusion of the fovea between patients with idiopathic epiretinal membrane (iERM) and normal controls and determine whether surgery affects it. PATIENTS AND METHODS: Both eyes of 45 patients with iERM and 28 healthy subjects were scanned by optical coherence tomography angiography (OCTA) preoperatively, and 25 of the patients were scanned postoperatively. Central parameters measured included flow area and parafovea vessel density of the foveal choriocapillaris. RESULTS: Both parameters were significantly lower in eyes with iERM (both P < .001) compared with both the unaffected fellow eyes and the normal control eyes (both P < .001) preoperatively, and they increased as the result of surgery, although it did not reach statistical significance. However, the differences between both eyes of patients became insignificant after surgery (both P > .05). CONCLUSIONS: OCTA may provide quantitative information regarding choriocapillaris perfusion. iERM influences the foveal choriocapillaris perfusion, which is reversible by surgery.