Background: Malignant glaucoma is an ocular emergency and may lead to blindness if not promptly recognized and treated effectively. It is usually reported after trabeculectomy, and spontaneous or bilateral cases are not common in the literature.Case report: This article reports the case of a Nigerian woman who developed spontaneous bilateral malignant glaucoma with resultant visual impairment. A literature review on the subject is also undertaken. Possible etiology and management challenges of the case are also discussed.Conclusion: This study is aimed at drawing attention to this potentially blinding eye disease, and ultimately improves knowledge on its diagnosis and management, to reduce the visual morbidity.Key words: Malignant glaucoma, closed angle glaucoma, blindness, visual impairment, aqueous misdirection, vitrectom