Purpose: To describe a case of p-ANCA associated vasculitis in a patient with bilateral vision loss with no systemic symptoms or signsMethods: A descriptive review of a caseResults: We report a case of bilateral sequential vision loss in a 73-year-old woman who had no constitutional symptoms except headache and was found to have positive p-ANCA and lymphocytic infiltration on bilateral temporal artery biopsy. Despite the early administration of systemic corticosteroids, the visual outcome was unfavorable.Conclusion: It is important to consider ANCA associated vasculitides when temporal artery biopsy does not support GCA.