PURPOSE: Metronidazole is a widely used antimicrobial and is generally well-tolerated, but its adverse effects can rarely manifest as ataxia, dysarthria, and encephalopathy. Rarely it can cause severe neurological toxicity in the form of Metronidazole-Induced Encephalopathy. METHODS: We report a 48-year-old female with acute cerebellar symptoms and altered sensorium following a 12-day course of Metronidazole. RESULTS: Magnetic Resonance Imaging (MRI) revealed unusual diffuse leukoencephalopathy involving the cerebellar, brainstem, and cerebral white matter with rapid clinical and radiological resolution occurred after discontinuation. CONCLUSIONS: This case highlights the importance of early recognition of symptoms and immediate discontinuation of Metronidazole to prevent irreversible neurological sequelae, even in cases with limited exposure.