A 25-YEAR-OLD MAN with symptomatic tethering of the cerebellum is presented. At the age of 8 days, the patient underwent a limited repair of a posterior fossa encephalocele. He was well until the age of 24 when he began to experience paroxysms of extremity weakness, progressive incoordination, and pain at the base of the skull. Imaging demonstrated a connection between the cerebellar vermis and the subcutaneous tissue underlying the site of the previous encephalocele repair. Exploration of the area with the release of a fibrous stalk resulted in the rapid resolution of the patient's symptoms.