This case report describes features and surgical management in one patient that developed a worsening total III cranial nerve palsy in his right eye. Our 45 year-old male patient worked for about 25 years in leather tanning industry. He underwent medical history, routine blood test, eye exams that included visual acuity measurement, slit-lamp examination, dilated retinal biomicroscopy and indirect ophthalmoscopy, fundus photography, tonometry, corneal pachymetry, Krimsky test, oculomotor examination and eye deviation surgery. On examination of the fellow eye wasn’t found any disease. Stroke, aneurysm and intracerebral causes of third nerve palsy were excluded, and medical history was negative for diabetes, cardiovascular disease, trauma, neurological disease unless two previous polyneuropathies episodes and one herpetic keratitis episode. Result of any neuroimaging studies were recorded (Our patients performed in hospital CT, MRI and MRI angiography and all the testes were normal). To our knowledge third cranial nerve palsy has never been observed in literature in leather workers. In conclusion, it is important for ophthalmologists to evaluate carefully work history and lifestyle persons and plan the surgical approach focusing the different characteristics of these patients.