Tehran University of Medical Sciences Case Reports in Clinical Practice 2538-2683 8 1 2023 07 22 42 45 Mohammad Taher Rajabi Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Abbas Mohammadi Farabi Eye Hospital, Tehran University of Medical Sciences, Tehran, Iran. Sajad Besharati School of Medicine, Shahid Beheshti University of Medical Sciences, Tehran, Iran. 2022 11 10 2023 04 10 Congenital orbital wall defects are very rare bone abnormalities that can cause protrusion of intracranial contents into the orbit. The protrusion of the meninges, which encompasses cerebrospinal fluid (CSF), result in a condition known as the orbital meningocele, a rare cause of pulsatile proptosis. Here, we present a 4-year-old female with left eye proptosis referred to our clinic. On magnetic resonance imaging (MRI), a cystic structure was present. The patient underwent surgery for cyst removal. CSF leakage was noted during surgery. Computed tomography (CT) scan revealed a bony defect in the sphenoid greater wing and the resulting meningocele. Craniotomy surgery was performed to close and fill the defect. https://crcp.tums.ac.ir/index.php/crcp/article/view/755