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The syndrome of pulmonary SARS-Cov-2 resulted in significant morbidity and mortality, with new variants spreading rapidly. Vaccines to prevent COVID-19 have been developed to minimize the impact and severity; however, adverse effects of the vaccine have been documented in several studies. In our case, we report a case of a young female who presented to the emergency department with fever, dizziness, headache, vomiting, blurring of vision, numbness, and weakness of left upper and lower limbs. This weakness progressed rapidly to all limbs within two hours associated with altered behaviors and visual hallucinations. The family reported a history of the patient receiving her first dose of COVID-19 AstraZeneca vaccine 18 days before admission. Based on her clinical picture and investigation, she was diagnosed with vaccine-induced immune thrombotic thrombocytopenia (VITT). She was treated successfully with intravenous immunoglobulin (IVIG) and direct oral anticoagulant apixaban. In a time when there is a strategic goal to vaccinate the global population from COVID-19 to inhibit the spread of infection and reduce hospitalization, this particular clinical scenario emphasizes the need for all clinicians to remain vigilant for rare complications of the COVID-19 vaccination., Competing Interests: The authors have declared that no competing interests exist., (Copyright © 2022, Sobh et al.)