Our recent experience with a patient who died from hemorrhage into a pineal ganglioglioma (pineal apoplexy) is reported. This case is unique because pineal apoplexy is rare and is usually diagnosed only at postmortem examination. Previous tumor irradiation and mild hypertension may have predisposed the patient to the hemorrhage. Our patient is probably only the second patient reported who underwent direct operation. The CT scan findings and pathology are presented.