A 54-year-old, previously healthy female with chronic meningoencephalitis is presented. Computed tomography (CT) revealed hydrocephalus and mass lesions in both the lateral and fourth ventricles. A culture of cerebrospinal fluid obtained from the lateral ventricle on admission was negative, but 2 years later, when the meningoencephalitis recurred, Cryptococcus neoformans was cultured. The diagnostic difficulties and CT features of intracranial cryptococcal granulomas are discussed.