Papilledema is one of the most alarming signs in clinical medicine. While there has been great progress in our understanding of obesity and Idiopathic Intracranial Hypertension (IIH) nearly 80 years ago, there is still much to be learned about the etiology, pathophysiology, and exact role of obesity in IIH, particularly within the pediatric population. The continued modification of the diagnostic criteria for IIH reflects this progress and will likely help physicians make more a more accurate diagnosis. We continue to see a strong association between IIH and recent weight gain, but encouragingly the converse appears to be true, as a similar amount of weight loss results in significant improvement. For the morbidly obese IIH patient, bariatric surgery is a likely effective treatment when noninvasive strategies have failed. Currently, studies of obesity markers in IIH patients have been inconclusive. More studies are needed for more association between obesity & IIH & role of obesity management to reduce IIH