AIM:To report unusual exacerbation of recurrent acquired ocular toxoplasmosis and improvement of visual outcome with proper treatment in an immunocompetent individual.METHODS:Case report.RESULTS:A 21-year-old Bisaya girl,otherwise healthy,with contact history with cats,presented with right eye painless and progressive blurring of vision for two weeks.The visual acuity was 6/15 in the right eye and 6/6 in the left eye.Fundus examination showed focal retinitis in the posterior pole with swollen hyperemic optic disc in the right eye and old retinochoroidal scars in the periphery of both eyes.She had right recurrent ocular toxoplasmosis that was confirmed with toxoplasma serology.Initially,she responded to two different treatments such as bactrim and azithromycin.Unfortunately,she developed two episodes of exacerbation of toxoplasmosis in right eye during the course of treatment.Her right eye visual acuity was decreased to 6/60.The medication regime consisted of oral azithromycin with tapering doses of corticosteroids was subsequently initiated in this patient for 6 weeks.The toxoplasmic retinitis in the right eye was resolved and there was no recurrence during the last 1 year follow-up.Her final visual acuity was 6/30 in right eye and 6/6 in left eye.CONCLUSION:Recurrent acquired ocular toxoplasmosis in an immunocompetent individual is not common.Delayed diagnosis and treatment result in permanent blindness.Prompt,adequate and compliance of treatment are essential to prevent this devastating visual complication.