Background: Posterior reversible encephalopathy syndrome (PRES) and reversible cerebral vasoconstriction syndrome (RCVS) although two independent clinical entities but can present in the same patient as a continuum of the same disease process. PRES can be characterized by varied neurological symptoms such as headache, impaired visual acuity or visual field deficit, confusion, impaired consciousness, seizures, and motor deficits. Ischemic infarctions in the territory of vasogenic edema post PRES is not uncommon. RCVS is typically associated with severe thunderclap headaches and reversible segmental vasoconstriction of cerebral arteries and is often complicated by ischemic or hemorrhagic stroke. More research is required to clearly delineate the link between them. Case: Here we report the case of a normotensive lady who in her post partum period developed severe holocranial headache with seizure and confusional state. A MRI Brain done showed T2 /FLAIR hyperintensities in bilateral parieto-occipital and frontal lobes suggestive of vasogenic edema and a diagnosis of PRES was made in her initial admission and she improved with conservative management. But soon after she again developed headache followed by dysarthria, left more than right sided weakness and right visual inattention and right-left disorientation. MRI Brain done now showed changes suggestive of PRES with associated infarcts. But a CT angiography done now showed evidence of intracranial vasospasm. Patient was diagnosed and managed like RCVS. However, no underlying cause of PRES/RCVS could be determined in her case except her postpartum period which could be considered as risk factor for both these conditions. Conclusion: This case highlights that PRES and RCVS although relatively uncommon neurological disorders, they share some common clinical and radiologic features and dilemma arises when clinico-radiological features suggestive of both conditions develop in same patient like seen in our case. Therefore, the two conditions can be thought of as a manifestation of same underlying disease process and further studies are required to establish this hypothesis.