Posterior Reversible Encephalopathy Syndrome (PRES) is a neurotoxic condition characterized by a unique pattern of brain vasogenic edema, often seen in association with complex conditions such as preeclampsia, allogeneic bone marrow transplantation, organ transplantation, autoimmune diseases, and high-dose chemotherapy. The imaging features of PRES are typically symmetric, affecting the parietal and occipital regions, with MR diffusion-weighted imaging (DWI) confirming vasogenic edema. Clinical symptoms include headache, vision changes, paresis, and altered mentation, often accompanied by moderate to severe hypertension. Laboratory findings may include endothelial injury, thrombocytopenia, and red cell fragmentation. The mechanism behind PRES remains controversial, with both hypertension and endothelial dysfunction being considered potential causes. Advanced imaging techniques, such as catheter angiography and MR perfusion, have been used to assess cerebral blood flow and vasculopathy. Histopathological studies have shown vasogenic edema, activated astrocytes, and lymphocytes, without significant neuronal damage. The diagnosis of PRES is challenging, and its management involves addressing the underlying condition and supportive care.Posterior Reversible Encephalopathy Syndrome (PRES) is a neurotoxic condition characterized by a unique pattern of brain vasogenic edema, often seen in association with complex conditions such as preeclampsia, allogeneic bone marrow transplantation, organ transplantation, autoimmune diseases, and high-dose chemotherapy. The imaging features of PRES are typically symmetric, affecting the parietal and occipital regions, with MR diffusion-weighted imaging (DWI) confirming vasogenic edema. Clinical symptoms include headache, vision changes, paresis, and altered mentation, often accompanied by moderate to severe hypertension. Laboratory findings may include endothelial injury, thrombocytopenia, and red cell fragmentation. The mechanism behind PRES remains controversial, with both hypertension and endothelial dysfunction being considered potential causes. Advanced imaging techniques, such as catheter angiography and MR perfusion, have been used to assess cerebral blood flow and vasculopathy. Histopathological studies have shown vasogenic edema, activated astrocytes, and lymphocytes, without significant neuronal damage. The diagnosis of PRES is challenging, and its management involves addressing the underlying condition and supportive care.