Background: Central variant of posterior reversible encephalopathy syndrome is clinico-radiological entity associated with hypertension,renal disease, cytotoxic immunosuppressive medications and autoimmune disease. We present a case of adult presented with uncontrolled hypertension and severe headache, unsteadiness of gait. Initial CT was done to rule of intracranial bleed showed hypodense area in pons. MRI finding showed vasogenic edema of brain stem leading to wide range of differential diagnosis. Follow up imaging within week shows marked resolution of MRI finding along with clinical improvement. This case represent importance of clinical and radiological corelation to diagnose central variant of posterior reversible encephalopathy syndrome, to avoid invasive investigation and treatment.It also emphasise the importance of awareness of this atypical central variant of PRES along with typical posterior cerebral variant.