There is a wide differential diagnosis for patients presenting with multiple cranial nerve palsies, including infectious, inflammatory, malignant, genetic, toxic, and metabolic conditions. This report describes the clinical features, neuroimaging findings, and response to surgical treatment in a patient with bilateral deafness and recurrent episodes of bilateral facial nerve palsy that were caused by renal osteodystrophy. It is suggested that renal osteodystrophy be considered in the differential diagnosis of multiple cranial nerve palsies in the appropriate clinical setting.