Cervical manipulation, specifically chiropractic manipulation, is an important cause of vertebrobasilar and occasionally carotid distribution strokes. Neuro-ophthalmologic findings are a common and at times relatively isolated feature of cervical manipulation-induced stroke. A case of chiropractic-induced occipital lobe infarction with homonymous hemianopsia is reported, and the literature regarding neuro-ophthalmologic findings is reviewed.