We report an adult end-stage renal disease patient with only cerebellum involvement of reversible posterior leukoencephalopathy syndrome (RPLS). A 37-year-old woman, diagnosed as chronic glomerulonephritis, was admitted to our hospital with progressive visual disturbance and severe headache. MRI revealed hyperintense signal intensity changes restricted in the cortex and subcortical white matter of the cerebellum. With appropriate control of blood pressure and intracranial pressure, her symptoms were improved and complete resolution of previous hyperinternse lesion was shown on MRI after the 19th day of admission. This is first case of isolated cerebellar involvement of RPLS without other cerebral involvement in an adult.