Bilateral anterior ischemic optic neuropathy and bilateral ocular ischemic syndrome have been rarely reported as initial manifestations of Takayasu's arteritis (TA). Appearance of ocular symptoms in TA is closely related to extension and severity of involvement of the aorta and its major branches. Here we reported a case of 'carotid steal syndrome' secondary to TA in a 45 year old Turkish man, who had severe ocular and brain ischemia, presented initially with symptoms of ocular ischemic syndrome.