Occipital condyle syndrome is a rare cause of pain in the head which is characterized by severe and persistent unilateral suboccipital headache with unilateral hypoglossal nerve palsy. We report an elderly female who presented with dysarthria and suboccipital headache. On further evaluation, she was found to have a solitary bone metastases from thyroid cancer. She was treated with local radiation therapy for pain relief, total thyroidectomy, and high-dose radioiodine therapy. The patient is presently free of pain with very good control of the thyroid cancer status.