Acute binocular visual loss, photophobia, headache, and pulsatile tinnitus developed in a 51-year-old woman. Ophthalmologic examination showed bilateral optic disc edema with peripapillary nerve fiber layer hemorrhages. Lumbar puncture disclosed a monocytic pleocytosis. A diagnosis of Vogt-Koyanagi-Harada disease was made. Magnetic resonance imaging showed striking enhancement and thickening of the posterior ocular wall. A macular star figure appeared several days after prednisone treatment was begun. Laboratory evaluation was entirely negative. Within weeks, the clinical manifestations had resolved except for retinal striae. This is the third report of the magnetic resonance imaging visualization of choroidal inflammation in Vogt-Koyanagi-Harada disease and shows the imaging abnormalities in finer detail than earlier reports.