Background: Non-arteritic anterior ischemic optic neuropathy (NAION) is an ischemic change involves the 1 mm thickness of the optic nerve head (optic disc). We depend on fundus fluorescein angiography (invasive investigation) and visual field for diagnosis of NAION. Optical coherence tomography angiography (OCT A) is a new modality (non-invasive) for assessment of vascular tissue at multiple retinal levels. We are seeking for a role of OCT A in diagnosis of NAION. Objective: The aim of the current study was to assess the optical coherence tomography angiography peripapillary perfusion density in diagnosed non-arteritic acute ischemic optic neuropathy patients within a period from one week to 3 weeks during (acute stage while the disc is still edematous) of acute painless diminution of vision. Patients and Methods: This study included a total of ten patients diagnosed with non-arteritic anterior ischemic optic neuropathy and 10 age-matched normal control individuals with normal RNFL thickness, attending at ophthalmology outpatient clinic of Al-Azhar University Hospitals. OCT A 6x6 on the disc is done for all subjects and control group with Zeiss angioplex (cirrus 5000). Results: showed a decreased perfusion density in a ring from 3 to 6 mm around the center of the disc in all quadrants except the lower one. Central to this ring, the perfusion density is higher in NAION cases, which may be due to superficial displacement of the deeper capillary plexa with edema. Conclusion: We can depend on the perfusion density in ring 3- 6 mm in diameter when assessing a case of acute NAION not the central circle.