Leptomeningeal metastases are broadly defined as the deposits of tumor cells with invasion of the meninges. The most common solid tumors known to cause this are breast cancer (12%-35%), lung cancer (10%-26%) and melanomas (5%-25%). Leptomeningeal metastases from nasopharyngeal carcinoma are rare and occur in almost 3% of patients. LM is often multifocal with simultaneous involvement of multiple areas of the craniospinal axis. Isolated LM is extremely rare. This is in sharp contrast to the frequent occurrence of direct intracranial extension. There are three membranes surrounding the brain and spinal cord: the dura mater, the arachnoid, and the pia mater. The arachnoid and pia mater are collectively called the leptomeninges. Tumor involvement of the leptomeninges, which is distinguished from tumor involving the dura mater, allows malignant cells to spread throughout the subarachnoid space, travel to distant sites, and grows. Patients with LM develop clinical manifestations over days to weeks. Multifocal neurologic signs are common and indicate multilevel involvement. Gadolinium enhanced MRI of the brain and spine often provides evidence of LM. The brain MRI typically showed a thin, diffuse leptomeningeal enhancement following the contours of the gyri and sulci or nodular deposits in the subarachnoid space. Common sites of leptomeningeal enhancement are the cerebellar folia, the cortical surface, and the basal cisterns. Linear or nodular enhancement can be showed along the surface of the cord or the cauda equina on spine MRI.