Nevus of Ota (NOO) is a dermal melanocytoses characterized by bluish-brown macules along the distribution of trigeminal nerve. Ocular involvement is observed in most of the patients in the form of scleral pigmentation. Also reported associations in this condition are iris/ciliary body pigmentation/glaucoma, ocular melanoma, etc. Hence, the terms nevus fusco-ceruleus ophthalmo-maxillaris and oculodermal melanocytosis are used to refer to this condition. Bilateral NOO is a rarely encountered condition, with only few scattered case reports in the literature. In this study, we report a rare presentation of bilateral NOO in four patients. The condition is important to recognize due to cosmetic concern it poses and limited treatment options.