Background: Cysticercal involvement of the spinal cord is a very rare form of neurocysticercosis. Intramedullary cysts are even less common. Objective: To describe a novel presentation of multilevel intramedullary neurocysticercosis with eosinophilic meningitis. Design: Case report. Patient: A 35-year-old man with a history of cerebral neurocysticercosis who presented with both cauda equina and Brown-Sequard syndromes associated with cerebrospinal fluid findings of eosinophilic meningitis. Results: Magnetic resonance imaging confirmed the multilevel intramedullary cord lesions. The patient was treated medically with dexamethasone and albendazole and had a good recovery. Conclusion: Intramedullary neurocysticercosis should be considered as a potentially treatable cause of multilevel spinal lesions with subacute meningitis.