A 19-year-old white male developed blindness in the left eye following a motor vehicle accident. Orbital echography and computerized axial tomography established the diagnosis of subperiosteal hematoma of the orbit. Emergency medical therapy and lateral canthotomy resulted in slight visual improvement but rebleeding occurred 12 hours after injury with visual loss. An emergency surgical decompression of the orbit was performed. Vision returned to 6/7.5 following decompression. This is the first report illustrating that orbital decompression can reverse complete visual loss from a subperiosteal hematoma of the orbit.