Cryptococcal infection of the central nervous system is a critical concern in immunocompromised patients. However, differentiating between cryptococcus infection and other meningeal processes, such as leptomeningeal metastasis, is occasionally challenging both clinically and radiologically. Herein, we report the case of a 64-year-old man with underlying stage IV lung adenocarcinoma with cryptococcal meningitis mimicking leptomeningeal metastasis.