An 18-year-old man reported rapid decrease of visual acuity that progressed to total blindness in 1 month. Computed tomographic scanning showed two neoplastic masses: a large one, intra- and suprasellar, and a smaller cerebellar nodule. Histologically, the former proved to be a large metastasis of the small cerebellar medulloblastoma, which infiltrated and compressed the chiasm. Direct compression of the optic pathways by metastasis of a medulloblastoma is a rare event.