Brain stem calcification on CT scan, suggesting prenatal brain stem ischemia, is reported in an infant with Moebius syndrome examined in the Department of Pediatrics and Neonatal Medicine, State University of Gent, Gent, Belgium. Attempts at oral feeding in the neonatal period resulted in cyanotic attacks and bradycardia. There were repetitive clonic flexion movements in the arms and tonic contractions of intercostal and diaphragmatic muscles leading to respiratory arrest. Anticonvulsant therapy including pyridoxine were without benefit. The face was mask-like, the tongue was small, the gag reflex weak, the voice low pitched, and there was inability to abduct either eye beyond the midline. When asleep, both eyes were incompletely closed. There was generalized hypotonia and areflexia. At six months of age head control with severe titubation was achieved but conjugate eye movements were absent. At 12 months of age she still could not sit independently and she was monitored at home because of an erratic bradycardia. EEG’s were normal. Chromosome test was normal. The right facial nerve could not be stimulated and blink reflexes were absent bilaterally. Brain stem evoked response showed bilateral anomalies. CT scan of the posterior fossa showed pontomedullary calcification in the floor of the fourth ventricle and basal cisterns were large. The case provides in vivo support to a theory of disruption in the vascular territory of the subclavian artery in explanation of the Moebius syndrome. [1]