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A left ophthalmoplegia and right hemiplegia were due to thrombosis of an intracavernous aneurysm with occlusion of the left internal carotid artery. Ophthalmoplegia with contralateral hemiplegia is probably a rare syndrome. Thrombosis of an intracavernous aneurysm is probably a rare cause of occlusion of the internal carotid artery.