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Posterior reversible encephalopathy syndrome (PRES) is characterized clinically by headache, seizures, vomiting, altered mental status, and blurred vision. However, with overlapping and atypical clinical symptoms, PRES becomes a diagnostic challenge. We describe the imaging findings of PRES in magnetic resonance imaging and F-fluorodeoxyglucose positron emission tomography-computed tomography in an 11-year-old child who presented with features of hypertensive encephalopathy.