Ramsay Hunt syndrome (RHS) with concomitant vocal cord paralysis (VCP) is a rare finding. This case is particularly rare because the patient lacked the symptoms of otalgia or hearing loss when in fact, a majority of cases typically demonstrate both hearing loss and otalgia. Unique to this case is also the fact that it was complicated by a concomitant infarction of the splenium corpus callosum and a right temporal meningioma. The purpose of this study was to bring awareness to the fact that RHS can cause multiple cranial nerve neuropathies including VCP and should be included in the differential diagnosis for VCP.