Enfortumab vedotin is an antibody-drug conjugate that was recently granted accelerated US Food and Drug Administration approval for the treatment of locally advanced or metastatic urothelial cancer. Early clinical trials identified blurry vision, increased lacrimation and other events associated with dry eye as potential side effects. We report a case of bilateral anterior subcapsular cataract development following initiation of enfortumab vedotin. Enfortumab vedotin is not previously known to cause cataract development or progression and, thus, our patient's presentation may reflect the first report of an undocumented adverse effect of this novel agent.