Medial medullary infarction is a rare type of stroke and is usually secondary to a large artery atherothrombosis and small penetrating artery disease. Bilateral medial medullary infarction is even less frequent with a much poorer outcome. We present the case of a 55-yearold Filipino male, hypertensive, who initially complained of vertiginous dizziness with signs and symptoms of right lateral medullary infarction. Within 24 hours of hospitalization, patient’s symptoms evolved into a bilateral medullary infarct. Up to this date, this is the first case report of a Wallenberg syndrome that evolved into a bilateral medial medullary infarct.