We report a case of isolated left peripheral hypoglossal nerve palsy caused by neurovascular compression associated with essential arterial hypertension. MR and MR-angiography revealed an anomalous course of the left vertebral artery and left PICA. A similar case, without arterial hypertension, was reported by Rollnik et Al.According to Jannetta's hypothesis neurovascular compression of the brain stem may cause essential arterial hypertension. To our knowledge no other similar case of peripheral hypoglossal palsy and arterial hypertension caused by neurovascular compression has been reported.The possible role of neurovascular compression in the pathogenesis of essential hypertension is briefly discussed.Paralisi periferica isolata del nervo ipoglosso associata ad ipertensione arteriosa da conflitto neurovascolare RIASSUNTO-Gli autori riportano un caso di paralisi isolata delt'ipoglosso sinistro da compressione neurovascolare associata ad ipertensione arteriosa essenziale.Lo studio RM, ed angio-RM, ha evidenziato un anomalo decorso delt'arteria vertebrate sinistra e delta PICA omolaterale.Viene brevemente discusso it possibile ruolo delta compressione neurovascolare nelta patogenesi delt'ipertensione arteriosa essenziale.