BACKGROUND: Idiopathic intracranial hypertension (IIH) is increasingly prevalent, yet longitudinal outcome data are scarce. This study aimed to characterise demographic and longitudinal clinical changes in a cohort of patients with IIH. METHODS: Retrospective cohort analysis on adult patients diagnosed with IIH (Friedman criteria) enrolled in the neuro-ophthalmology database (NODE) across two tertiary centres. Baseline demographic data was obtained at first assessment, with clinical and paraclinical outcomes collected longitudinally. Multivariable statistical analysis identified factors associated with poorer visual outcomes. RESULTS: A total of 221 patients were included. 91.8% were female (ratio 11:1). Mean age at presentation was 29.2 ± 8.1 years with mean body mass index (kg/m CONCLUSIONS: This study offers insights into visual outcomes in IIH, emphasising the importance of early recognition, risk stratification, and intervention in those with a more severe clinical phenotype at presentation.