Postoperative visual loss (POVL) is a rare but potentially devastating complication associated with spine surgery. In 1999, the American Society of Anesthesiologists Committee on Professional Liability established a POVL Registry to examine cases in search of common elements. Most cases of POVL after spine surgery which have been reported to the POVL Registry have been associated with intraoperative prone positioning. We present an atypical case that occurred after spine surgery performed in the lateral decubitus position.