A 39-year-old Chinese man developed ocular ischemic syndrome (OIS) in both eyes 14 years after radiation therapy for nasopharyngeal squamous cell carcinoma. Digital subtraction angiography disclosed occlusion of common carotid arteries and stenosis of both vertebral arteries. Following stenting of the vertebral arteries, visual function improved and ophthalmoscopic abnormalities of OIS regressed in the right eye. Radiation therapy of the head and neck has a relatively high likelihood of causing vascular stenosis. However, we believe this to be the first reported case of OIS following radiotherapy for nasopharyngeal carcinoma.