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In this paper, we present a case with acute vision loss due to ethambutol therapy. A sixty-three year-old man underwent tuberculosis treatment (Ethambutol, Izoniazid, Rifampicin, Pirazin Amid) six years before this report. Acute bilateral vision loss occurred three months later while receiving ethambutol treatment. Total vision loss in one eye, and partial vision loss in another eye and optic atrophy were found on physical and neurological examinations. Ethambutol is one of the major drugs in tuberculosis treatment. It is usually well tolerated; however an Important side effect of this drug is retro bulbar optic neuropathy, which should be considered. Background: Toxic optic neuropathy, optic Atrophy, tuberculosis, ethambutol Key words