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Fat embolism syndrome (FES) is characterized with petechiae, mental confusion, and respiratory failure, occurs generally after lower extremity long bone fractures or orthopedic surgery within 24-72 hours. Isolated cerebral fat embolism occurs at a rate of 0.9-2.2% that is a fatal event. The clinical diagnosis of isolated cerebral fat embolism is difficult since neurological symptoms are variable. On the other hand methemoglobinemia is a rare complication occurring after administration of local anesthetics. We aimed to present a case in whom isolated cerebral fat embolism and methemoglobinemia caused by intraoperative high dose of local anesthetic agents and who was taken to operation in the first 24 hours because of the left femoral diaphysis fracture in this study.