In a series of 11 patients with classic pituitary apoplexy, two patients had the acute onset of bilateral blindness. After transsphenoidal decompressive surgery both patients had useful recovery of vision. Although impairment of neurologic function appears irreversible when central nervous tissue has been compressed to the point of total loss of function it would appear that the optic chiasm may be an exception to this experience. Our review of the literature and our experience suggests that decompression can be worthwhile even late in the course of this disease and visual loss should not be treated expectantly.