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Vincristine, a widely used chemotherapeutic agent, may rarely cause optic neuropathy leading to acute vision loss. We describe a patient with T cell lymphoblastic lymphoma who developed sudden bilateral visual impairment following the third cycle of vincristine-based chemotherapy. Extensive evaluation excluded alternative causes, including central nervous system infiltration, opportunistic infections and metabolic disturbances. A diagnosis of vincristine-induced optic neuropathy was made. The patient received high-dose intravenous methylprednisolone along with pyridoxine supplementation, resulting in marked visual recovery within days. This case highlights a potentially reversible but under-recognised complication of vincristine therapy. Early recognition and timely intervention are crucial to prevent permanent visual disability.