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<p><strong>Background:</strong> Orthostatic tremor is an uncommon disorder manifest by high frequency, low amplitude leg tremor upon weight bearing. Treatment with oral tremor agents is inconsistent and usually not satisfactory.</p> <p><strong>Methods:</strong> We implanted bilateral ventralis intermedius nuclei deep brain stimulators into an 82-year-old male with refractory orthostatic tremor.</p> <p><strong>Results:</strong> The patient had a marked subjective and objective improvement in leg and arm tremor, mainly manifested by an improved ability to stand.</p> <p><strong>Discussion:</strong> Bilateral thalamic deep brain stimulation may be considered in refractory cases of orthostatic tremor.</p>