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To report a case of acute transient myopia with anterior chamber shallowing induced by sulfamethoxazole in a patient with pseudoxanthoma elasticum (PXE).Observational case report.A case report of a 45-year-old woman who presented with bilateral acute myopia, anterior chamber shallowing, and intraocular hypertension induced by sulfamethoxazole and was found to have PXE. Initial and follow-up examination findings were reviewed.On first examination, bilateral myopic shift of 4.25 D, bilateral narrowed angles, and ocular hypertension (36 mm Hg right eye and 38 mm Hg left eye) were found. Pentacam images documented the anterior displacement of the iris-lens diaphragm. Undilated fundus examination disclosed bilateral angioid streaks radiating from the papilla. Several redundant skin folds on the neck and axillae were found on external examination. With sulfamethoxazole discontinuation and administration of topical intraocular pressure–lowering drops, there was complete clinical resolution within 1 week. The diagnosis of PXE was confirmed by biopsy of the skin lesions.Acute myopia with angle narrowing is an extremely rare sulfamethoxazole side effect, and its relationship, if any, with PXE is unknown. As far as we know, this is the first reported case of PXE presenting with bilateral angle narrowing induced by sulfamethoxazole.