We present the case of the patient S.M., female, 32 years old, who came in our eye clinic for left painful ophthalmoplegia. The onset of the clinical manifestations was a year and half ago, with the decrease of visual acuity at left eye, left partial ophthalmoplegia (partial lesion of the left oculomotor nerve) and secondary left trigeminal neuralgia. The paraclinical investigations excluded the systemic and locoregional diseases. CT exams, the left internal carotid angiography and the surgical intervention at the Neurosurgery Clinic in Timişoara revealed a left juxtasella tumor at the base skull, located extradural, which capsule invade the left nerve oculomotor. We conclusion that the painful ophthalmoplegia are complex clinical syndromes, with a different etiopathogenesis (inflammatory, tumoral, vascular malformations: aneurysm etc.) and their diagnosis and treatment need a good interdisciplinary collaboration: ophthalmologist-neurologist-neurosurgeon-endocrinologist-paraclinical exams.