Toxoplasma gondii infection is an uncommon and potentially life-threatening condition in immunocompromised patients in the setting of solid organ transplantation. We present the case of cerebral toxoplasmosis which presented as a solitary intracranial space-occupying lesion in a patient who received a combined kidney and pancreas transplant more than twenty years ago. Initially, the lesion was considered as a primary brain malignancy based on brain imaging but surprisingly the brain biopsy led to the correct diagnosis.