With the improved resolution of the newer B-scan instrumentation, echography can be used to confirm rapidly and accurately the diagnosis of optic disc drusen. Over a 4-year period, we retrospectively identified 48 patients with the echographic diagnosis of optic disc drusen. Ages ranged from 6 to 78 years. Drusen were echographically bilateral in 69% of these patients. In 30 eyes, drusen were not visible clinically but were detected echographically. Standardized A-scan echography also helped to confirm the diagnosis of pseudotumor cerebri (2 patients) and optic neuritis (2 patients), emphasizing the need for performing a thorough evaluation before attributing clinical findings of an ophthalmoscopically abnormal optic nerve head to optic disc drusen. Six of 48 patients had vascular occlusions at the level of the optic nerve head. In 5 of these 6 patients, unilateral deep optic disc drusen were detected on the side of the occlusion. This finding lends support to the theory of potential mechanical compression of vascular structures by optic disc drusen.