Primary central nervous system lymphoma of T-cell lineage (PCNSTL) is an extremely rare entity, with relatively few cases reported in the literature. Presented here is a case of a 44-year-old, HIV negative woman found to have a solitary cerebellar lesion following presentation to the Emergency Department with a fall. The lesion responded to emergent dexamethasone and was followed with serial MRI imaging, which continued to show lesion regression. The lesion was shown to have recurred on MRI 14 months post-presentation and found to be T-cell lymphoma following immunophenotyping and TCR gene rearrangement studies of tissue specimen obtained via excisional biopsy.