Background/Aim: To describe a case of invasive orbital aspergillosis and evaluate treatments and outcomes. Methods: A case report and review of orbital aspergillosis treatment with voriconazole in the English language literature. Conclusion: Amphotericin B with debridement is the current standard of care for orbital aspergillosis; however, its prognosis is unfavorable. When compared to amphotericin B, voriconazole demonstrates a survival benefit, has less systemic toxicity, and is better tolerated by patients. While a prospective trial comparing amphotericin B to voriconazole in orbital aspergillosis is not feasible, there is evidence to support the use of voriconazole as primary therapy.