Idiopathic Intracranial Hypertension is one of the causes of blindness in the modern world. It affects usually overweight female patients in their childbearing age. Unfortunately, there are no clear quidelines in respect of the best possible approach to treat this rare condition. Conservative treatment which means weight loss, acetazolamide prescription and close follow up and on the other hand surgical treatments are the main options. Ventriculoperitoneal shunt to relieve intracranial pressure and Optic Sheath Fenestration are both surgical options that can be also combined treat patients and save their vision decline [1,2]. In this study, we retrospectively reviewed different techniques of optic sheath fenestration and measured the outcome and the complication rate of each one.