Central retinal artery occlusion (CRAO) is a sight-threatening condition resulting from occlusion of the central retinal artery and hypoperfusion of the inner retina. Early on, fundal examination may be normal. The authors present a retrospective case series of 11 patients to report the OCT findings of impending or occult CRAOs, which may help with earlier detection of the condition. The OCT of all the patients demonstrated inner retinal oedema with hyperreflectivity and prominent middle limiting membrane. The mechanisms behind these findings are considered to be the result of retinal ischaemia leading to cellular damage and retinal oedema in the acute phase, eventually progressing to atrophic changes in the chronic phase. The authors conclude that the recognition of inner retinal ischaemia on OCT is often an under recognised sign in occlusive arterial aetiology. Increased awareness may help facilitate prompt recognition and therefore earlier diagnosis and referral to stroke services.