Idiopathic intracranial hypertension (IIH), also known as pseudotumor cerebri, is characterized by an increased intracranial pressure (ICP) without space-occupying lesions or secondary causes. First identified in 1893, its diagnosis relies on neuroimaging (primarily magnetic resonance imaging - MRI) to exclude other conditions. Key MRI markers include empty sella, posterior globe flattening, distention of the perioptic subarachnoid space, and transverse venous sinus stenosis. The diagnostic criteria have evolved from the Modified Dandy Criteria using CT scans to incorporating MRI and MRV findings, particularly for cases without papilledema. It’s essential to differentiating idiopathic from iatrogenic IIH by excluding causative drugs, as their treatment and progression differ. MRI findings typically associated with IIH are not uncommon in other conditions, such as primary headache syndromes, or in asymptomatic individuals, with empty sella being particularly prevalent (8–35%) in the general population, especially in women and obese individuals. This can lead to over-referral, invasive testing, and potential over-diagnosis, particularly in obese women. A recent study of 296 participants (median age 49.5 years, 63.5% female) found that nearly half (49%) had at least one radiographic sign of IIH, including empty sella (33.1%), enlarged Meckel caves (15.9%), and increased perioptic cerebrospinal fluid (10.8%). However, papilledema was rare, occurring in only 1.7% of participants, and was associated with higher BMI, history of IIH, and multiple MRI signs (e.g., empty sella, optic nerve tortuosity, and transverse venous sinus stenosis). The prevalence of papilledema increased significantly among patients with four or more MRI signs (40%), highlighting that the presence of papilledema defines a subgroup warranting further diagnostic evaluation. Iatrogenic intracranial hypertension is a rare secondary cause of an already uncommon condition and has not been systematically studied in the literature. When identified, discontinuing the causative drug often leads to partial or complete resolution of clinical and neuroimaging signs. In refractory cases, standard IIH management is typically applied, as the drug may act as a trigger for an underlying, previously undiagnosed condition.