Subdural empyema usually occurs in the second decade of life. Paranasal sinus infection or middle ear infections are the most common etiology of this condition. Interhemispheric subdural empyema is very rare condition. The most appropriate treatment is surgery.  We describe a 16 years old boy with interhemispheric subdural empyema who had no complaints or history of sinusitis or otitis media. He introduced with fever, nausea, vomiting, seizure and hemiparesis. Our diagnosis with imaging determined and demonstrated interhemispheric subdural empyema. After the antibiotic treatment the patient went under operation and drainage of empyema. After the operation all of complaints of the patient improved. We suggest that if all patients with history and symptoms of paranasal sinusitis and middle ear infection have symptoms of ICP rising, Falx syndrome or seizure, the existence of SDE should be checked.