A 63-year-old female with a history of hyperlipidemia, tobacco use and recent admission for myopericarditis presented with a one-month history of hand weakness, balance issues, and fingertip numbness. MRI showed multifocal infarcts involving anterior and posterior circulation, many following the internal and external border zone pattern with no significant extra- or intracranial stenosis on the concurrent CTA head and neck. Transthoracic echocardiogram did not reveal an intracardiac source; PFO was noted. Initial consideration was given to cardioembolic etiology in the setting of recent left heart catheterization or a paradoxical embolism given a PFO was found on echocardiogram. However, watershed distribution on MRI was inconsistent with a stereotypical cardioembolic pattern, and further investigation revealed an eosinophil count of 4.45 cells/nanoliter. On retrospective review, hypereosinophilia was also present one month prior during her myopericarditis admission. The patient met diagnostic criteria for HES and was started on high dose steroids. No alternative etiology for HES, such as infection or malignancy, was discovered.