Horner syndrome describes the triad of ptosis, miosis, and anhydrosis that results from disruption of the oculosympathetic pathway. It is often associated with specific clinical features based on the location of the culprit lesion and can range from benign to life-threatening conditions, including carotid artery dissection and malignant neoplasms. We reviewed the anatomy of the oculosympathetic pathway, the clinical approach to Horner syndrome, and the imaging findings of lesions associated with Horner syndrome at different levels of the oculosympathetic pathway. Learning Objective: We suggest appropriate imaging strategies for Horner syndrome based on the patient's clinical presentation and laboratory investigations.
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