Primary pituitary lymphoma (PPL) is an exceedingly rare clinical entity in immunocompetent individuals. It has several clinical features including hypopituitarism, headache, hemianopia, diplopia, and fever. Here we present a 57 year old woman who came to our clinic complaining of headache, nausea, vomiting, and blurred vision. Laboratory investigations revealed elevated prolactin level and panhypopituitarism. Moreover, pituitary enhanced magnetic resonance imaging (MRI) was performed, and it revealed 2.1 cm pituitary macroadenoma. The patient was started on cabergoline then present later with worsening of her symptoms, increase in the mass size, with optic chiasm compression