<p>Simultaneous paralysis of the hypoglossal and the recurrent laryngeal nerves is known as Tapia syndrome, which can be a rare complication of orotracheal intubation. The underlying mechanism is typically related to airway manipulation, resulting in direct compression or excessive stretching of the nerves. We present a case of a patient with recent acute ST-segment elevation myocardial infarction (STEMI) treated with coronary stent, who developed acute dysphonia, right lingual hemiatrophy with ipsilateral deviation of the protruded tongue following prolonged intubation. The clinical and radiological picture was consistent with iatrogenic post-intubation neuropathy, an extremely rare occurrence. The patient was managed conservatively, with speech therapy rehabilitation. This case highlights the importance of early recognition of post-intubation cranial nerve palsy and the crucial role of imaging in confirming diagnosis and guiding clinical management.</p>