We encountered a 49-year-old female presenting with left oculomotor palsy who was found to be co-localized cavernous sinus cavernous angioma (CA) and pituitary adenoma. Although CA originated from parasellar regions are not so rare, on neuroimaging studies, the characteristics of CA may be difficult to differentiate from those of pituitary adenomas. The co-localization of these two tumors was identified by preoperative dynamic MRI study. As intraoperative histological examination confirmed our preoperative diagnosis, we performed biopsy of the CA only to avoid uncontrollable intraoperative hemorrhage. © 2008 Elsevier Ireland Ltd. All rights reserved.