Purpose: To report a case of spontaneously improved visual acuity in a patient with suprasellar meningioma. Case summary: A 55-year-old female presented with decreased visual acuity for 1 week. She had chronic headache and ocular pain. Her visual acuity of the right eye was 0.1 and temporal and inferior visual field defects were found. Relative afferent pupillary defect was observed in the right eye. On orbital magnetic resonance image, a homogenous enhancing mass with a broad dural base at the

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... jugum sphenoidale was found. This was likely to represent a meningioma and was referred to neurosurgery. The patient refused the surgery and did not receive any treatment. After 1 month, the visual acuity of the right eye improved to 0.5. The improved vision remained until 6 months later. Conclusions: Visual loss associated with meningioma can spontaneously improve and this should be considered when making diagnostic and treatment decisions for meningioma. J Korean Ophthalmol Soc 2021;62(3):414-418