Ojective To evaluate the therapeutic efficacy of surgical and nonsurgical treatment and the clinical factors affecting the efficacy in traumatic optic neuropathy. Methods To analyse retr ospectively the efficacy of recovery of visual acuity in 40 cases of traumatic optic neuropathy after treatment with transnasal endoscopic sphenoethmoidal optic canal decompression (28 cases) and drug therapy (12 cases). Results No significant difference existed between the therapeutic efficacy of surgery and that of drug therapy in patients with the visual acuity of LP～ 0.02. In surgery group,the therapeutic efficacy of the patients with visual acuity of LP～0.02 was better than that of the patients with no LP.The therapeu tic efficacy of patients with duration shorter than seven days before sutgery is better than that of patients with duration longer than seven days. Conclusions The patients with serious traumatic comperssive optic neuropathy should not be treated with decompressive surgery and should not delay to at most seven days after injury.With or without the visual acuity of light perception of the affected eye surgery is usually an important factor affecting the therapeutic efficacy. (Chin J Ocul Fundus Dis, 2001,17:204-206)