PURPOSE: of Review: The novel coronavirus, SARS-CoV-2 is the most critical public health challenge in recent history. In this report, we present a case of suspected acute hemorrhagic encephalitis with bilateral intracranial hemorrhages associated with COVID-19 infection RECENT FINDINGS:: A 48-year-old female COVID-19 positive patient developed acute changes in her neurological status. A head CT with CT angiography demonstrated extensive bilateral parietal and occipital intraparenchymal hemorrhage with intraventricular extension and acute hydrocephalus. The patient was treated with an external ventricular drain (EVD) and a CSF sample was tested for SARS-CoV-2 but was found to be negative. SUMMARY:: The underlying mechanism for developing acute hemorrhagic encephalitis in viral illnesses may be autoimmune in nature and warrants further investigation. The initial neurologic presentation of COVID-19-related hemorrhagic encephalitis is altered level of consciousness which may prompt further neurologic examination and imaging to exclude this feature.