PURPOSE To report a patient who developed accommodation and convergence palsy caused by lesions in the bilateral rostral superior colliculus. DESIGN Observational case report. METHODS A 30-year-old right-handed man experienced sudden onset of diplopia and blurred vision at near vision. RESULTS The patient showed accommodation and convergence palsy. Magnetic resonance imaging revealed lesions located in the bilateral rostral superior colliculus. CONCLUSION These findings suggest that the rostral superior colliculus is involved in the control of accommodation and vergence eye movements.