PURPOSE: To report a rare case of bilateral intravitreal onchocerciasis presenting with panuveitis and managed successfully through combined medical and surgical interventions. METHODS: A 42-year-old female with bilateral panuveitis and suspected intravitreal nematodes underwent comprehensive ophthalmologic evaluation, systemic investigations, and bilateral pars plana vitrectomy. Extracted nematodes were identified through macroscopic and molecular analysis. RESULTS: The patient presented with decreased vision and panuveitis in both eyes. Vitrectomy revealed fragmented nematode tissues, later confirmed as Onchocerca at the genus level. Postoperatively, the inflammation resolved and visual acuity returned to normal. CONCLUSION: It is important to recognize intravitreal parasitic infections in patients with unexplained uveitis, particularly in endemic or rural exposure settings. Combined medical and surgical management resulted in favorable visual and clinical outcomes.