Herein, we describe a case of parasellar meningioma, with extension into orbital apex and optic nerve, in a patient presenting with ipsilateral choroidal folds.

This report describes a patient who presented with an acute painful pupil involving third nerve palsy, which on neuroimaging was found to be due to a pituitary adenoma with parasellar extension.

Internal carotid artery (ICA) injury is the most dangerous and life-threatening complication in patients operated on due to parasellar tumors via a minimally invasive endoscopic endonasal approach.