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Cerebrovascular accidents are a life-threatening complication in renal transplant recipients. The risk increases with old age, diabetic neuropathy, and peripheral vascular disease. Ischemic stroke contributes to two-thirds of stroke in renal transplant recipients. As they receive immunosuppressives, they are more susceptible to a spectrum of opportunistic infections. Central nervous system infections such as tuberculosis and fungal infections can present as ischemic stroke. Cerebral infarction in meningoencephalitis is due to strangulation of vessels by exudates which causes vasculitis with inflammation, spasms, constriction, and thrombosis. This case report is a rare presentation of stroke in renal transplant recipient due to an infective etiology. The patient was managed appropriately by understanding this underlying pathophysiologic mechanism.