Background:: Cavernous angiomas (CAs) of cranial nerves are rare, and their occurrence on the third cranial nerve is particularly rare. Surgical management of such CAs involving the third nerve is controversial. We describe a case of a symptomatic CA of the oculomotor nerve and review the literature in order to ascertain the relevance of surgical intervention. Case Description:: A 71-year-old male patient presented with a 2-month history of progressive oculomotor nerve paralysis. CA of the oculomotor nerve was suspected on magnetic resonance imaging (MRI). The patient underwent complete resection of the CA through a subtemporal approach, preserving the integrity of the nerve. Histopathological analysis confirmed the diagnosis of CA. Despite optimal resection, the patient did not improve postoperatively. Conclusion:: CAs of cranial nerves can cause rapid or progressive neurological deterioration. Whereas delayed treatment often leads to irreversible deficits, early nerve-sparing surgical excision of the CAs may potentially restore function.