We report a 67-year-old female diabetic with homonymous hemianopia as the presenting sign of nonketotic hyperglycemia. Magnetic resonance imaging (MRI) was abnormal with diffuse bilateral hyperintense white matter changes. A follow-up MRI scan 15 years later showed persisting abnormality. Her hemianopic visual field loss was reversed after correction of her hyperglycemia. Diabetes mellitus should be considered with the sudden onset of a homonymous hemianopia.