Purpose: To evaluate the sensitivity and specificity of multispectral imaging (MSI), a noninvasive imaging technique composed of a series of monochromatic scanning light, for polypoidal choroidal vasculopathy (PCV). Methods: This was a prospective observational study. Polypoidal lesions on MSI are defined by oval or lobular hyperreflective oval lesion with dark hyporeflective center. Branching vascular networks on MSI is featured by hyperreflective interlacing signal. Detection sensitivity and specificity of polypoidal lesions was compared with indocyanine green angiography, whereas sensitivity and specificity of branching vascular networks, subretinal fluid, and pigment epithelium detachment were compared with optical coherence tomography. Results: Among 67 eyes, 38 eyes (56.7%) were diagnosed with PCV, 7 eyes (10.4%) with neovascular age-related macular degeneration, 13 eyes (19.4%) with central serous chorioretinopathy, 6 eyes (9.0%) with pathological myopia, and 3 eyes (4.5%) with idiopathic choroidal neovascularization. Compared with indocyanine green angiography, the sensitivity and specificity for diagnosing PCV by MSI alone was 84.21% and 93.10%, respectively, and the positive predictive value and the negative predictive value for PCV by MSI was 94.12% and 81.82%, respectively. The sensitivity and specificity for detecting polypoidal lesions were 84.21% and 93.10% compared with indocyanine green angiography. Compared with optical coherence tomography, the sensitivity and specificity for detecting branching vascular networks were 95.83% and 88.37%, for the subretinal fluid were 76.92% and 86.67%, and for the pigment epithelium detachment were 91.11% and 90.91%, respectively. Conclusion: Multispectral imaging allowed noninvasive visualization of polypoidal lesions and branching vascular networks and may serve as a new diagnostic option for PCV.