A 67-year-old man suffered right hemiparesis 6 weeks after the onset of left herpes zoster ophthalmicus. This is the first case, to our knowledge, with both angiographic proof of segmental narrowing in the proximal portion of the middle cerebral artery and computerized tomographic abnormality consistent with cerebral infarction on serial tests. Delayed hemiparesis contralateral to herpes zoster ophthalmicus probably is caused by a hemispheric stroke secondary to granulomatous angiitis.