Posterior Reversible Encephalopathy Syndrome (PRES) is a clinico-neuroradiological entity with neurological symptoms and characteristic radiologic findings. It may complicate eclampsia either during pregnancy or in the puerperal period and it is a very serious neurological condition manifesting as acute headache,impairment of consciousness, seizures, cortical blindness and occasionally, focal neurological signs accompanied by a typical CT or MR imaging pattern.A 30 years old right handed primigravida housewife was managed for PRES and this is the first reported case in Sierra Leone. Clinicians in Africa should consider this diagnosis in all cases of eclampsia in order to reduce the morbidity and mortality that may result from delayed diagnosis.