Anti-N-Methyl-D-Aspartate receptor encephalitis is a recently described neurological disorder , an immune-mediated encephalitis caused by production of antibodies to the NMDA receptor. It is now a recognised cause of psychosis, movement disorders and autonomic dysfunction. Though it is the second most frequent cause of immune mediated encephalitis it is usually under diagnosed Many anaesthetic medications interact with NMDA receptors, thus, implicating risks to the induction and maintenance of anaesthesia in these patients. We report a patient with documented anti-NMDA receptor encephalitis who was scheduled for surgery for Right salpingo-oopherectomy under general anaesthesia.