I report an association between Crohn's disease and bilateral phakic cystoid macular edema. A 51-year-old man with a diagnosis of Crohn's disease was referred for evaluation of decreased vision bilaterally. He had bilateral phakic cystoid macular edema, with a vision of 20/40 in the right eye and 20/60 in the left eye. Over a 2-year period, the patient was treated with nonsteroidal agents, as well as steroids, systemically, topically, and periocularly. Each recurrence of the Crohn's disease was associated with a worsening of the bilateral phakic cystoid macular edema. During the treatment period, the patient did not have clinical evidence of intraocular inflammation. Bilateral phakic cystoid macular edema may be associated with Crohn's disease, despite the lack of clinical evidence of intraocular inflammation.