The authors investigated a case of surgically verified solitary left thalamic abscess in a 37-year-old man presented with raised intracranial pressure and congenital heart disease(ventricular septal defect). He had experienced headache, vomiting and right hemiparesis, which progressed to somnolence and confusion. Brain computed tomography(CT) and magnetic resonance image(MRI) demonstrated a left thalamic ring-enhanced lesion. The purulent material was drained and subtotal excision was done with a transcallosal transventricular craniotomy. Concomitant systemic antibiotics therapy was a dministered.