Objective: The paper describes the case of a 27-year-old, right-handed woman, KF, who sustained a left thalamic ischemic infarct. KF's case is unusual in that she presented with ipsilateral hemiparesis. No similar cases were found in the existing literature. Young-Mok et al. (2005) describe two cases of ipsilateral hemiparesis following a corona radiata infarct that they attribute to re-organization of the brain following previous right-sided supratentorial stroke; however, there is no radiologic evidence of prior stroke for KF. Method: KF reported that on July 15, 2008 she had difficulty awakening and problems with vision and comprehension. Her mother noted that KF was disoriented, had slurred speech, and did not understand the seriousness of her situation. She presented to the emergency department with visual disturbance and unsteady gate. An MRI (July 15, 2008) revealed subacute left thalamic ischemic infarct. Results: Results of neuropsychologic evaluation suggest characteristic cognitive difficulties consistent with left thalamic infarct: verbal expression impairment (mildly impaired verbal abstract reasoning, mildly impaired vocabulary, borderline semantic fluency), memory deficits (visual memory mildly impaired initially and profoundly impaired following delay, word list learning severely impaired and delayed word list recall profoundly impaired), as well as exacerbation of premorbid attentional difficulties (sustained visual attention profoundly impaired). She also presented with characteristic right-hand fine motor dexterity deficits (borderline) and uncharacteristic left hemiparesis (severely impaired left hand strength and fingertip dexterity). Conclusions: KF's case offers the opportunity to discuss possible explanations for the observed deficits that are previously not described in the literature. This case allows for further understanding of the motor pathways through the thalamus.