Objectives: This study investigated the treatment response to Korean medicine of a paraneoplastic cerebellar degeneration (PCD) patient with dysarthria and weakness of distal extremity.Case presentation: A 53-year-old female diagnosed with PCD complained of dysarthria and weakness of distal extremity. During 32-day hospitalization, she was treated with Korean medicine, namely, herbal medicine (modified Gamiguibi-tang), acupuncture (15 minutes twice a day at CV23, HT7, LI4, LR3, ST36, SP6, GB20, TE17, PC6, GV20, Ex-HN1, GV24 etc.), moxibustion, and cupping, combined with Western medicine (prednisolone, azathioprine) and physical therapy. Post-treatment, the patient global assessment (PGA) score of dysarthria fell from 100 to 60; grasp power rose from 15 kg to 19 kg and 13 kg to 17 kg in the right and left hands, respectively; and the 5-level EQ-5D version (EQ-5D-5L), EQ visual analogue scale (EQ-VAS), and Beck depression inventory (BDI-II) scores changed from 10 to 8, 0 to 80, and 34 to 7 respectively. Follow-up visits continued for about a month after discharge, improvement in symptoms maintained, and there were no significant side effects.Conclusions: Given the lack of standard treatment for PCD, Korean medicine can be tried clinically for the treatment of PCD patients with dysarthria and weakness of distal extremity. However, further studies with control groups are needed.