Recovery from a large primary pontine hemorrhage is a very unusual condition. A 46-year-old man developed a sudden cerebrovascular attack resulting in tetraplegia. He had a large centrally located primary pontine hemorrhage with dimensions of 35,1 mm X 19.5 mm that was revealed by computerized tomography. He recovered almost totally. We always have to be aware of the level of consciousness while evaluating the prognosis of a primary pontine hemorrhage. By means of this case we propose a new insight for the prognostic evaluation of primary pontine hemorrhage.