Eight-and-a-half syndrome is a clinical syndrome with the combination of a one-and-a-half syndrome and an ipsilateral seventh cranial nerve palsy usually due to a paramedian pontine tegmental lesion. A 57-year-old man presented with dizziness, diplopia, and a left facial palsy. Ocular motor manifestations showed combined left conjugate horizontal gaze palsy and left internuclear ophthalmoplegia (one-and-a-half syndrome). In addition, he had a left lower motor neuron pattern of facial palsy. Brain MR images showed an acute infarction in the left paramedian pontine tegmentum.