Primary empty sella (PES) syndrome is a rare and benign condition usually with no symptoms, and, often revealed incidentally. But at times the syndrome manifests with a wide and variable range of ocular and endocrine features. Central retinal vein occlusion (CRVO) is in and of itself a rare cause of blindness, and its presence in the context of primary empty sella is even rarer. In this article, the authors report a case of a hypertensive man in his late thirties presenting to the medicine inpatient with headache and blindness of the left eye. Investigations came up with the diagnosis of PES syndrome with CRVO with macular edema. However, this patient had no overt endocrine problems.