Background: Respiratory syncytial virus (RSV) is a common childhood respiratory pathogen, with many reported extrapulmonary manifestations. Neurological involvement was once believed to be temporary or reversible. Case presentation: We report a case of watershed stroke in a young child, occurring as an unexpected complication of severe RSV bronchiolitis. Unexpectedly, brain diffusion-weighted MRI proved that seizures in our patient were a consequence of more significant peripheral perfusion failure and stroke. Conclusion: It is important to distinguish the reversible effects of RSV from those alternative pathological sequelae necessitating changes in clinical management and re-prognostication

Keywords: Infarction, seizure, Respiratory Syncytial Virus, case report