We describe a case ofa venous hemangioma that arose in the optic nerve sheath ofthe orbital apex in a 28-year-old man who presented with progressive vision loss. Tothe best of our know ledge, this is the first reported case ofa venous hemangioma occurring at this location. A definitive diagnosis and partial exci sion was achieved via an endoscopic transsphenoethmoid approach with interactive, computerassisted, frame less stereotactic surgical navigation. The interv ention resulted in minimal morbidity, demonstrating yet again that this surgi cal approach is a safe and effective way to treat lesion s of the orbital apex.