The compression of anterior visual pathway (AVP) structures can be observed on neuroimaging. It is not clear whether or not this compression results in damage to these structures. The authors present a single centre retrospective case record review over the period 2011-2017 to explore this compression. The aim was to determine whether AVP compression by intracranial arteries may be a causative factor in patients with otherwise unexplained visual dysfunction. A secondary aim was to examine the natural history of visual deficits in patients with vascular compression of the AVP. The study included 37 patients with evidence of intracranial artery AVP compression as demonstrated on magnetic resonance imaging. Variables were collected to include patient demographics, visual acuity, visual fields, pupillary reactions and optic disc appearance. Results showed that visual field deficits correlated with compression sites in all 37 patients examined. The authors concluded that AVP compression by intracranial arteries may be a causative factor in unexplained visual dysfunction. The visual defects reported were largely non-progressive in nature.