Background: Bilateral thalamic infarctions can arise from arterial or venous causes. Arterial occlusion, most commonly involving the artery of Percheron, and venous thrombosis of the deep cerebral veins and straight sinus are the principal mechanisms. Cerebral venous thrombosis is rare, accounting for less than 1% of all strokes, with deep venous system involvement being particularly uncommon. Case Report: We report an elderly patient who presented with bilateral haemorrhagic thalamic infarcts secondary to deep cerebral venous thrombosis involving the internal cerebral veins, straight sinus, and transverse sinuses. The patient was managed with anticoagulation and anti-edema measures, resulting in near-complete neurological recovery. Despite extensive evaluation, no underlying etiological factor for deep cerebral venous thrombosis could be identified. Conclusion: This case highlights deep cerebral venous thrombosis as a rare but important cause of bilateral thalamic infarction. Prompt recognition and appropriate anticoagulant therapy can lead to favourable outcomes, even when the aetiology remains undetermined.