The author describes optical coherence tomography (OCT) findings in a patient with central retinal artery occlusion by conducting a retrospective review of one case. Central retinal artery occlusion shows a distinct pattern on OCT images. In the acute phase, OCT images demonstrate the increased reflectivity and thickness of the inner retina and a corresponding decrease of reflectivity in the outer layer of the retina and retinal pigment epithelium/choriocapillaris layer. Follow-up OCT images demonstrate a decrease in the reflectivity and thickness of the inner retinal layers and a corresponding increase of reflectivity in the outer retina and retinal pigment epithelium/choriocapillaris layer compared with the baseline OCT image, suggesting a generalized atrophy of the neurosensory retina as a late finding. Therefore, the use of OCT may help facilitate prompt recognition of acute and chronic central retinal artery occlusion.