We report the case of a 76-year-old male previously known with ischaemic heart disease, diabetes mellitus, hypertension and hypercholesterolaemia, who presented with a 14-day history of radicular neck pain, binocular diplopia and a left partial oculomotor palsy. Cerebrospinal fluid analysis showed lymphocytic pleocytosis and an intrathecal synthesis of IgG and IgM antibodies against Borrelia burgdorferi was confirmed. This case report highlights the importance of remembering Lyme neuroborreliosis in the differential diagnosis of diplopia and oculomotor palsy.