Objective: To compare and quantitatively analyze the different characteristics of multimodal imaging of parapapillary atrophy (PPA) in patients with high myopia. Methods: This was a case series study that included multimodal images of 45 eyes with PPA in 30 high myopia patients. There were 13 males (19 eyes) and 17 females (26 eyes). Age ranged from 27 to 69 years, with a mean age of 53.1±11.6 years. All eyes were examined by color fundus photography (CFP), near infrared spectrum fundus autofluorescence (NIR-FAF), fundus fluorescein angiography (FFA) and spectral domain optical coherence tomography (OCT). Using image J software, two trained ophthalmologists, operating in masked fashion, graded lesions in the CFP and NIR-FAF areas independently and compared the size of the PPA area. OCT was performed to confirm the border of the lesion when NIR-FAF and FFA were difficult to determine. The consistency of the results between the two ophthalmologists was analyzed by Bland-Altman. results:The PPA areas of CFP, NIR-FAF and FFA were 7.1±4.7 mm 2 , 8.3±5.8 mm 2 , 8.1±5.5 mm 2 . The differences in the PPA area between the three multimodal image groups were not statistically significant (F=1.193,P=0.307). The consistency of the results between the two ophthalmologists was high, with a variation range of CFP<NIR-FAF<FFA. conclusions: The mean differences in the size of the PPA measured by CFP,NIR-FAF and FFA are not statistically significant.