A 57-year-old woman who had hypotension and cardiac arrest during coronary artery bypass grafting developed hypotensive ischemic optic neuropathy with no light perception vision OU. Bilateral mid-orbital optic nerve enhancement was found on magnetic resonance imaging (MRI) eight weeks after surgery. Re-examination 16 weeks after surgery showed no light perception vision, dilated un-reactive pupils, and pale optic discs. Bilateral optic nerve enhancement persisted on MRI. Optic nerve enhancement has been reported commonly in radiation-induced ischemic optic neuropathy, occasionally in arteritic ischemic optic neuropathy, and rarely in nonarteritic ischemic optic neuropathy. It has never been reported in hypotensive ischemic optic neuropathy.