PURPOSE: To describe a patient with Osler-Rendu-Weber syndrome who developed a nonsimultaneous intraoperative choroidal hemorrhage in each eye. METHOD: Interventional case report. A 65-year-old Caucasian woman with Osler-Rendu-Weber syndrome developed a choroidal hemorrhage in the left eye during vitrectomy for a complicated retinal detachment with a poor visual outcome. Fifteen years later, she developed a macula on retinal detachment in the right eye, which also had a dense cataract. Immediately after uncomplicated phacoemulsification and intraocular lens implantation, under monitored anesthesia care and retrobulbar block, and without valsalva stress, ophthalmoscopy demonstrated a choroidal hemorrhage. A planned scleral buckle was replaced by pneumatic retinopexy. RESULTS: Seven months postoperatively, the retina remained attached with resolution of the choroidal hemorrhage. Visual acuity was 20/30. CONCLUSION: Choroidal hemorrhage may occur more commonly in individuals with Osler-Rendu-Weber syndrome. Recognition of this possible association and institution of appropriate intraoperative precautions may facilitate a good visual outcome.