A case of a solitary cerebellar tuberculoma in a 67-year-old male is presented. The patient showed signs and symptoms of acute obstructive hydrocephalus, necessitating surgical removal of the tumor. Combined treatment with antituberculosis drugs, not only pre and postoperatively but also intraoperatively, proved beneficial, and postoperative meningitis did not develop. Steroids also produced dramatic clinical improvement without causing spread of the tuberculosis. Since intracranial tuberculoma is rarely encountered in present-day Japan, it is not likely to be considered when signs and symptoms suggest an intracranial mass lesion. Therefore, it must be emphasized that the first and most important step in the diagnosis of intracranial tuberculoma is to suspect it. The incidence and ages of patients as well as the locations of intracranial tuberculomas, their relationship to tuberculous abscesses, neuroradiological features, and therapeutical methods are reviewed.