Hypertrophic olivary degeneration (HOD) is caused by the damage of dentator rubroolivary pathway which triangular area is consisted of red nucleus, dentate nucleus, inferior olivary nucleus and the connection fibers. It usually resulted from vascular damage in pons or cerebellum, and also fromencephalitis, degenerative disease, multiple sclerosis, tumor and trauma. We experienced this case of a 56-year-old man with characteristic clinical findings of HOD such as palatal myoclonus, ipsilesional facial palsy, crossed hemiplegia and truncal ataxia after right pons and midbrainhemorrhage. Therefore we report this case with observation of olivary nucleus size in brain MRI followed up after 5 years.