A 65-year-old gentleman with Waldenstrom's macroglobulinemia on zanubrutinib complicated by biopsy-confirmed AHL amyloidosis, which was further complicated by cardiomyopathy, nephropathy, and recurrent pleural effusions presented with encephalopathy and was found to have multifocal acute, symmetric, subcortical strokes. There was no evidence of prior strokes or chronic small vessel disease on MRI. A comprehensive stroke work-up was unremarkable, including typical vascular risk factors within goal, negative blood cultures, normal d-dimer, normal serum viscosity, no radiographic evidence of large vessel disease, and no arrhythmia on telemetry. Echocardiogram showed bi-atrial enlargement related to cardiac amyloid, but no evidence of atrial, ventricular, or perivalvular thrombus. Lumbar puncture was performed and revealed WBC 10, RBC 9, glucose 16, and protein 154. Cryptococcal antigen was positive at a titer of 1:64. Amphotericin B and flucytosine were initiated with clinical improvement over two weeks and he was transitioned to fluconazole for maintenance therapy and prophylaxis.