A case of non-insulin dependent diabetes mellitus with anterior ischemic optic neuropathy accompanied by acute sensorineural hearing loss is presented. The patient was a 53-year-old woman with diabetes mellitus and hypertension of 8-years duration. She experienced sudden blurred vision in the left eye accompanied by tinnitus and sudden sensorineural hearing loss within a week. Physical examination revealed bilateral carotid bruits and impaired deep tendon reflexes. Magnetic resonance imaging showed multiple subcortical infarcts without specific symptoms or signs. Ophthalmological and otological diagnoses were anterior ischemic optic neuropathy and sensorineural hearing loss respectively. She was treated with urokinase, prostaglandin E1 and Vitamin B, after which only hearing acuity improved. We suspect that atherosclerotic changes in the cerebrovascular system, associated with diabetes mellitus and hypertension, are responsible for the lesions.