Patients with anterior ischemic optic neuropathy due to giant cell arteritis are thought to develop optic disc cupping, resembling that seen in glaucomatous eyes, while such cupping does not seem to occur in nonarteritic anterior ischemic optic neuropathy. However, this remains controversial. We describe a patient with arteritic anterior ischemic optic neuropathy (the clinical diagnosis was confirmed with a biopsy from the temporal artery) who developed disc cupping within 4 months after acute episode. This patient never had elevated intraocular pressure, and prior to the acute event the optic nerve heads had had a normal appearance with a physiologic cup.