To describe a case of endogenous endophthalmitis (EE) following severe COVID-19 disease, review patient outcomes with EE following COVID-19 infection, review evidence regarding risk factors for developing EE. Review of health records, imaging, intravitreal injection, and pars plana vitrectomy for bilateral fungal EE following severe COVID-19 disease. Literature review on outcomes in EE following COVID-19 disease. 63 year-old male with diabetes and hypertension was admitted to hospital for severe COVID-19 disease for 3 months. His stay required ICU admission, intubation, high-dose corticosteroids, tocilizumab, and was complicated by bacteremia, empyema, and fungal esophagitis. He developed floaters and bilateral vision loss (visual acuity 20/40 OD, CF OS) with vitritis 2.5 months into his stay that did not respond to intravitreal voriconazole. Pars plana vitrectomy was performed for both eyes, resulting in visual acuity of 20/40 OD, 20/30 OS. Vitreous cultures were positive for candida albicans. EE following COVID-19 disease has been reported in 22 patients to date, and outcomes are poor, with 40%+ of eyes legally blind (20/200 or worse). Although influenced by availability of imaging modalities and degree of training of the evaluating physician, misdiagnosis can affect ¼ of cases, delaying treatment. Age, male gender, and diabetes increase risk of severe COVID-19, which requires prolonged hospitalization, invasive catheretization, and immunosuppression, which in turn increases risk of nosocomial infection. Low threshold for suspecting endogenous endophthalmitis in patients presenting with floaters and decreased vision following severe COVID-19 disease is necessary to ensure prompt recognition and treatment.