Introduction: Tranexamic acid (TXA) is an antifibrinolytic agent widely used to reduce bleeding in surgical and trauma settings. While generally well-tolerated, neurological complications including visual disturbances have been reported with high-dose administration, particularly in pediatric populations who may exhibit increased sensitivity to its effects. Case presentation: An 11-year-old girl (35 kg) received intravenous TXA 30 mg/kg for menorrhagia, triple the standard recommended dose of 10 mg/kg. Approximately 10 minutes post-administration, she developed sudden-onset tunnel vision, escribing her visual field as ""looking through a straw ."" She remained alert and oriented with stable vital signs throughout. Neurological examination revealed bilateral peripheral visual field defects with preservedcentral vision. Pupils were equal, reactive, with intact accommodation. No other neurological deficits were observed. The patient underwent continuous neurological monitoring without additional pharmacological interventions. Within 60 minutes of symptom onset, tunnel vision resolved completely with full restoration of normal peripheral vision. Follow-up ophthalmological examination at 24 hours demonstrated no residual visual defects. Conclusion: This case demonstrates a rare but reversible neurological complication of highdose TXA in pediatric patients. The mechanism likely involves TXA crossing the blood-brain barrier and interfering with GABA neurotransmission in visual processing centers. The rapid onset and spontaneous resolution suggest a dose-dependent, temporary effect. Healthcare providers should maintain strict adherence to dosing guidelines and recognize potential visual disturbances promptly to ensure optimal patient safety .