Septic cavernous sinus thrombosis is a rare but serious complication of infection of the cavernous sinuses. Potential therapies include antibiotics, corticosteroids and anticoagulation, as well as surgical intervention for source control of the infection. The authors report that there is a lack of randomised controlled trials of any of these treatments and therefore treatment remains varied and lacking in an evidence base. The authors report a case study of a patient with this condition who eventually had a favourable outcome, detailing lessons learnt during the course of treatment. They go on to report a review of the existing literature regarding treatment of this condition. The article includes a full list of the literature found with details of treatment and outcomes where published. Following their comprehensive literature review, it is clear that evidence for treatment is lacking and that further studies are required to determine the optimal therapy for this condition.