Ophthalmoplegia syndrome or Tolosa Hunt syndrome (THS) is a rare severe unilateral periorbital headache associated with painful and restricted eye movements (ophthalmoplegia) with no visual deterioration. It is associated with choric inflammation with granulomatous deposition in cavernous sinus and at superior orbital fissure. This article provides a detail outlook of this syndrome that along with pathophysiology, the present diagnostic considerations and management insights on Tolosa-Hunt syndrome through review of published article.