A 16-year-old girl with worsening vision, new OD visual field deficits, and tumor in right orbital apex underwent biopsy and surgical excision. Orbital imaging revealed an apical tumor causing bony erosion. Histopathology confirmed the diagnosis of nodular fasciitis. This is a rare diagnosis, and one that can mimic a neoplastic process. To the authors' knowledge, this is the first case of nodular fasciitis in the deep orbit and the first case of nodular fasciitis causing an optic neuropathy.