We studied 30 men with cranial neuropathy (CN) and systemic malignancy to determine the etiology and prognosis of CN. The most common malignancy was prostate (33%), followed by lung (27%). The etiology of CN was metastatic in 25 (83%) and nonmetastatic in 5 (17%). Only 6 patients improved: 3 metastatic and 3 nonmetastatic. Although prognosis for recovery was better in the nonmetastatic group, there was no significant difference in survival between the metastatic and the nonmetastatic groups.