Concurrent macular telangiectasia type 2 (MacTel) and branch retinal vein occlusion (BRVO) have not been described before and can pose a diagnostic dilemma. The current report highlights the role of multicolour (MC) imaging and blue reflectance (BR) imaging in diagnosing this multi-pathology. A 60-year-old male presented with diminution of vision in the right eye. BR imaging showed parafoveal hyperreflectance, characteristic of MacTel, and hyperreflective parafoveal retinal vessels indicating vascular changes in RVO. MC imaging, particularly the BR component is a promising tool to aide in the diagnosis of concurrent MacTel and BRVO, guiding treatment decisions and prognosticating treatment outcomes.