OBJECTIVE To report the very early magnetic resonance imaging features of eclampsia. METHODS Case report. METHODS Inpatient neurology service. METHODS A 35-year-old woman who developed late postpartum eclampsia with cerebral edema, caudate hemorrhage, and ischemic strokes. Main Outcome Measure Very early magnetic resonance imaging features. RESULTS Magnetic resonance imaging with gadolinium showed posterior sulcal hyperintensity and leptomeningeal enhancement preceding the development of posterior reversible encephalopathy syndrome, hemorrhage, and ischemic strokes by days. CONCLUSIONS Magnetic resonance imaging with gadolinium shows early characteristic findings that precede the more classic clinical presentation of eclampsia.