Background: Bilateral medial medullary syndrome is a rare type of stroke which results due to occlusion of the anterior spinal artery or vertebral artery or its branches. Clinical diagnosis without neuroimaging is very difficult, the characteristic brain MRI finding of “heart appearance” at DWI has been described in bilateral medial medullary infarct. Case Report: We hereby report 52 year old with acute onset quadriparesis. MRI scan of brain, diffusion weighted (DW) imaging revealed heart shaped hyper-intensity areas in the bilateral medial medulla. Conclusion: MRI with diffusion-weighted imaging helps in timely diagnosis of bilateral MMI in the acute setting and consequently decreasing the possibility of long-term disability.