Bilateral carotid-cavernous fistula (CCF) was diagnosed for a 74-year-old woman who had bilateral exophthalmus, chemosis and visual disturbance. High intraocular pressure, ocular motor disturbance, pallor of optic discs were also evident in both eyes. CT showed bilateral dilated superior ophthalmic veins. The angiographic diagnosis was bilateral spontaneous CCF (Barrow type D), showing bilateral feeding to each CCF. Exophthalmus and chemosis were reduced and visual function improved following superselective embolization. Although bilateral CCF as the present case has been reported previously only in twenty cases in the literature, we thought that bilateral CCF should be considered as a differential diagnosis for bilateral exophthalmus in aged people.