IN CYSTICERCOSIS, THE central nervous system is one of the most commonly affected sites; the clinical manifestations of this disease in the central nervous system can be very severe. The nature and intensity of the signs and symptoms depend on the location of the parasite; cysticerci situated in the cysternae may cause arachnoiditis and vasculitis, but the manifestations are rarely the result of their mass effect. We report the case of a 52-year-old woman with a racemose cysticercus in the left cerebellopontine angle, who presented with contralateral trigeminal neuralgia. The parasite was completely removed via a left suboccipital craniotomy. On the first postoperative day, the patient indicated that the pain had disappeared. The neuralgia was possibly caused by the distortion of the brain stem and the compression of the nerve against an arterial loop at the entry zone. This case demonstrates the advisability of obtaining imaging studies in all patients with trigeminal neuralgia before starting any treatment.