This controlled, randomized, single-blind study included patients diagnosed clinically with ocular toxoplasmosis, as defined by the presence of visual complaints and an area of focal necrotizing retinochoroidal lesion appearing as a whitish yellow region with a blurred margin plus or minus the accompaniment of an old lesion. Patients were recruited from the Nikookari Hospital Uveitis Clinic, Tabriz, Iran. Patients consented to participation in the study, and it was approved by the ethics committees of the hospital and the Tabriz University of Medical Sciences. Of the 72 patients enrolled in the study, all completed follow-up. 36 patients were treated with the classic regimen consisting of Pyrimethamine and Sulfadiazine, and 36 were treated with Azithromycin. An initial loading dose of 100 mg of Pyrimethamine , followed by a 50-mg dose daily, and sulfadiazine with loading dose of 2 gr followed by 500-mg dosing every 6 hours, and 5 mg of Folinic acid daily as the classic treatment protocol was used. In the other group, 1 tablets of Azithromycin 250 mg daily was used . In both groups, drugs were continued for 6 weeks; oral Prednisolone was administered at 1 mg/kg daily starting from the third day of therapy, and the dose was tapered over 2 weeks. Response to treatment was identified as sharpening of the lesion border with or without hyperpigmentation and resolution of vitreous inflammation