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Auditory disorders resulting from focal brainstem lesions are rarely symptomatic. Isolated lesions of the inferior colliculus have previously been reported, whereas no detailed description of a localized involvement of the lateral lemniscus is yet available. We report a unilateral lesion of the lateral lemniscus by a bleeding in a cavernoma. Symptoms included strictly contralateral tinnitus and auditory impairment, with normal pure-tone and speech audiometry. Conversely, the dichotic listening test revealed an extinction of contralateral ear input. The brainstem auditory evoked potentials disclosed a reduced and delayed wave V only after contralateral ear stimulation, while the middle latency evoked potentials were normal. This observation shows that a unilateral lesion of the lateral lemniscus can produce auditory symptoms. The dysfunction of auditory pathways is associated with specific electrophysiological abnormalities that can be assessed by evoked potential recording.