A 74-year-old man who had suffered from right herpes zoster ophthalmicus developed ipsilateral multiple cranial nerve involvement two weeks later. He showed right visual disturbance, total ophthalmoplegia and peripheral facial palsy. Pleocytosis and increased protein were found in CSF. Titer of VZV antibody increased in serum and CSF. CT and MRI demonstrated no abnormal findings in the brain stem. Within a month, peripheral facial palsy improved. Severe extra-ophthalmoplegia began to improve after three months, and moderately recovered. After two and a half year, visual disturbance and mydriasis showed no improvement. In this case, we speculate that localized leptomeningitis caused multiple cranial nerve involvement.