Tegmental pontine infarctions make up only a small portion of all isolated pontine infarcts. These lesions cause isolated cranial nerve palsies, neuro-ophthalmologic signs, and sensory deficits. Clinical and anatomic correlation of these lesions has been made simple with the use of cranial magnetic resonance imaging (MRI). In this article, we report on a 43-year-old hypertensive woman with bilateral horizontal gaze palsy and peripheral facial paralysis but no limb weakness. Pontine paramedian tegmental infarct was visible on cranial MRI.