<p>Antiphospholipid syndrome (APS) is an autoimmune disorder featuring antiphospholipid antibodies and a propensity toward thrombosis. APS rarely presents with concurrent cerebral venous and arterial thrombosis, but if present, it poses both diagnostic and management challenges. In this report, we provide a clinical case involving an Asian 45-year-old male patient who presented with a sudden-onset decreased level of consciousness and right-sided hemiplegia, which was subsequently diagnosed as APS. Upon investigation, there was an infarct in the middle cerebral artery (MCA) territory as well as thrombosis in the left internal carotid artery, transverse sinus, sigmoid sinus, and internal jugular vein. Laboratory values showed the presence of lupus anticoagulant antibodies that indicated APS, which served as a diagnostic marker. The administration of aspirin as a therapeutic intervention was initiated for the patient; however, it was subsequently discontinued as a result of the occurrence of hemorrhagic transformation. Following the clearance of the hematoma, the administration of aspirin was resumed, resulting in a notable enhancement in the individual’s degree of consciousness. The presence of APS in male patients, involving both cerebral venous and arterial thrombosis at the same time, is not seen very often. Both early identification and effective care of a condition are crucial to mitigating the occurrence of serious consequences. When both cerebral venous and arterial thrombosis happen at the same time, it is important to use a multidisciplinary approach to find and treat APS as soon as possible. The prompt beginning of therapy can be essential to mitigating potentially fatal outcomes. This case report contributes to the existing body of literature on the management of APS as well as the infrequent co-occurrence of both cerebral venous and arterial thrombosis in a male patient.</p>