Objects: A 4-year-old boy is here presented with the signs of increased intracranial pressure including headache, vomiting, and sixth cranial nerve palsy. Methods: The magnetic resonance imaging revealed symmetrically enlarged thalami with increased intensity on T2-weighted images. Magnetic resonance spectroscopy revealed decreased N-acetylaspartate levels with normal choline, creatinin, and lactate levels. The definite diagnosis of bithalamic glioma was made by lesional biopsy. Conclusion: Bilateral thalamic gliomas are uncommon tumors with wide variety of symptoms. Typical radiological features, however, might suggest the diagnosis.