Background: Mucoceles are most frequently seen in the frontal sinus but may arise in the ethmoid and rarely in the sphenoid sinus.Case Report: We present a case of a patient with bilateral visual compromise as a result of optic nerve compression from a large sphenoid mucocele. The diagnosis was based on CT and MRI scans. This patient was managed by endoscopic marsupalization of mucocele. Post-operatively, there was immediate improvement in his vision, which was completely restored over a period of weeks.Conclusions: Our case highlights that the endoscopic approach can be a convenient and successful method of dealing with cases, in experienced hands.

Keywords: sphenoid mucocele