Summary:A 14-year-old boy was referred with complaints of decreased vision, pain, and diplopia that developed in his right eye after trauma. Radiologic studies showed an orbital roof fracture with an associated subperiosteal hematoma. Orbital exploration with surgical drainage of the hematoma and roof fracture repair was performed. Postoperatively, he experienced complete visual recovery with resolution of his proptosis and diplopia. Subperiosteal hematomas of the orbit should be considered in the differential diagnosis of acute unilateral proptosis after trauma. The authors suggest that early intervention results in rapid patient recovery.