We present a fatal case of amoebic encephalitis due to Acanthamoeba spp. in an immunosuppressed male. Amoebic encephalitis can be a diagnostic challenge as clinical features are non-specific and imaging findings resemble other more common diagnoses such as tumours, haemorrhage or encephalitis from other causes. Here, we present the diagnostic imaging findings in this case and review the reported imaging findings in other cases throughout the literature.