Background: Oculomotor (CN III), trochlear (CN IV), and abducens (CN VI) nerve palsies cause ocular motility disorders and diplopia. Lesions can occur at the nuclear, fascicular, or infranuclear level, with varied aetiologies such as vascular, inflammatory, neoplastic, or traumatic causes. Clinical localization supported by radiological correlation is essential for accurate diagnosis and management. Hence the present study was taken up to find out clinical profile, risk factors, aetiology, clinic radiological correlation and outcome of nuclear and infranuclear lesions of third, fourth and sixth cranial nerve palsy in a tertiary care centre.

Methodology: It is a hospital based, prospective, observational study done in the department of neurology, government general hospital, Guntur from February 2023 to July 2024

Results: A total of 50 patients were studied. Mean age of onset was52.34 years. Females outnumbered males with a ratio of 1.17:1. 3rd cranial nerve involved more commonly constituting 63% of cases. Most common etiology is diabetic cranial mono neuropathy seen in 20 % of cases, followed by idiopathic intracranial hypertension in 12% of case, infective etiology in 10% of cases, 1 case is congenital nerve palsy. 68% cases showed complete recovery, 22% did not show improvement, 6% showed partial recovery,

Conclusions: From our study, we found that vascular risk factors which were treatable are the common cause. neuroimaging has definable role in defining diagnosis and localisation. Infective causes still constituted significant proportion.