A 31-year-old, HIV-negative, female with RRMS, who self-suspended fingolimod one month prior, was admitted to our hospital for disseminated cryptococcosis of skin and joints, and headaches. Her neurological exam was normal. Head CT unremarkable. Meningeal involvement was confirmed on cerebrospinal fluid (CSF) analysis by positive cryptococcus neoformans PCR, fungal cultures, and antigen titer (1:2560). She was started on amphotericin and flucytosine. Episodes of intracranial hypertension were managed with therapeutic lumbar punctures. After two weeks, CSF cultures negativized and antigen titer decreased (1:80). She then developed severe monocular decreased visual acuity and color desaturation in the left eye. Brain and orbits MRI revealed six new active supratentorial plaques, and peripheral enhancement of the left optic nerve. Balancing the risk of ongoing severe infection, patient was started on methylprednisolone, 1gm daily for three days, followed by oral prednisone taper. Her visual acuity rapidly stabilized, without clinical worsening of cryptococcal meningitis. She was discharged on oral fluconazole for one year, without plan to restart any disease-modifying-therapies in the foreseeable future.