Neuromyelitis optica (NMO) is an inflammatory demyelinating disease that preferentially affects the optic nerves and spinal cord. It has a worldwide distribution and distinctive clinical, neuroimaging and laboratory findings that distinguish it from multiple sclerosis. In most cases there is a long interval be- tween the optic neuritis and myelitis but approximately 10 to 20% can have near simultaneous occur- rence of both. We report a case of NMO presenting with symptoms and signs of optic neuritis and transverse myelitis which was later confirmed by neuroimaging and laboratory findings. The acute at- tack was treated with pulse therapy of corticosteroid and subsequently the patient was maintained on Azathioprine and tapering dose of oral steroid. This case highlights a neurological disorder that is in- creasing in prominence and may become more relevant in our region with increased diagnostic utility of antibody testing.