Tuberous sclerosis (TS) is a well-recognized cause of symptomatic seizures, and rarely coexists with acquired lesions such as neurocysticercosis. We present a 6-year-old boy with tuberous sclerosis and a limited form of epileptic spasms who had, in addition, two coexisting cerebral cysticercal cysts. The association was an incidental finding, but the cerebral tubers could be mistaken for perilesional edema of cysticercal cysts, especially if the clinical features of TS were subtle and not carefully looked for. Our case illustrates the diagnostic and therapeutic implications of recognizing the proximate cause of seizures, such as TS, when the incidental finding of cysticercal cysts might confound the clinical picture in endemic areas.