Introduction: Pseudotumor cerebri causes symptoms of intracranial hypertension and visual alterations secondary to damage to the optic nerve and the retina. Case Report: Hispanic 11-year-old male, obese. Presents to ER with recurrent visual alterations and vomit. Besides arterial hypertension and fundoscopy with hemorrhages, exudate, papilledema and silver-wire vessels. With a normal cranium tomography and a cerebrospinal fluid pressure of 38 cm H2O, management was started for pseudotumor cerebri. Visual recovery was limited due to severe damage to the retina and the optic nerve. Conclusions: In pseudotumor cerebri, visual damage can be permanent if proper treatment is not initiated early. With extensive retinopathy, malignant hypertension must be ruled out.