Primary angiosarcoma of the central nervous system (PACNS) is an extremely rare malignancy. The meninges represent an uncommon site of origin of PACNS. This report describes a recurrent meningeal PACNS treated with paclitaxel in an effort to raise awareness and suggest treatment options for this rare entity. A 36-year-old man presented to our facility with a 4-month history of worsening headaches and complete right homonymous hemianopia. Neuroimaging revealed a left occipital lobe hematoma with an underlying left tentorial tumor. After maximal resection, neuropathological examination revealed features of a malignant endothelial cell angiosarcoma. Of note, two years prior to presentation he had an acute intraparenchymal hemorrhage in the same location without clear etiology. Patient received adjuvant conformal radiation therapy (6040 cGy in 33 fractions) but experienced progression by imaging in less than a year. He subsequently received stereotactic radiosurgery followed by weekly paclitaxel (90mg/m2) day 1, 8 and 15 in 4-weeks cycle based on literature suggesting activity of this regimen in advanced angiosarcomas. He is tolerating treatment with stable disease for at least 6 months and retains a good performance status. This case of a meningeal PACNS highlights the importance of recognizing this entity in the setting of hemorrhagic lesions of the CNS. To our knowledge, this is the first report of the usefulness of paclitaxel in the treatment of this rare malignancy. This case will be updated at the time of the meeting.