West Nile virus is a neurotropic virus transmitted to humans via an infected mosquito bite. The increase in the incidences and fatalities of West Nile virus disease has made West Nile virus an important pathogen. Here we describe a case of a 65-year-old man with fever and diplopia presenting to the emergency department during a fall season and who was later diagnosed with West Nile virus infection. Diplopia is an uncommon manifestation of West Nile virus and recognition of the different modes of presentation, especially the uncommon ones like diplopia, will aid in the diagnosis of this emerging infectious disease.