Tranexamic acid (TXA) is widely used in Otolaryngology, Head and Neck surgery (OHNS) due to its antifibrinolytic properties, and commonly administered post-tonsillectomy haemorrhage and sinonasal surgery. Although TXA’s typical side effects include abdominal pain, dizziness, thrombotic and neurological events, visual disturbances remain exceptionally rare, with only one documented case by Kiser et. al. in a coagulopathic 7-year-old patient receiving TXA for epistaxis. This report describes two cases of acute visual disturbances following TXA administration in young, healthy patients. Both cases involved 25-year-old Caucasian females (SB and BL) with no significant medical history, who presented with low-volume post-tonsillectomy haemorrhage managed conservatively. Each patient received 1g of intravenous TXA. Approximately one-hour post-infusion, both patients experienced sudden and distinct visual changes: one reported peripheral colour vision turning orange, while the other noted an overall yellow tint to their vision. Both these patients reported their visual changes resolved over the following hour. TXA was ceased immediately in each case following these reports, and an ophthalmology consultation requested. Visual acuity, visual fields, extraocular movements and pupillary responses were all preserved in both cases. These evaluations provided reassurance, and both patients’ colour disturbances resolved entirely after discontinuation of the TXA, with no further episodes. These cases highlight a rare and potentially reversible adverse effect of TXA that clinicians should be aware of, particularly in OHNS where TXA use is frequent. While the mechanism behind these visual side effects remains unclear and any relation to the rate/flow of administration, recognising this unusual reaction is essential for patient safety and could enhance informed consent discussions regarding TXA.