We report a case of Anti-N-Methyl-D-Aspartate Receptor (NMDAR) Encephalitis we encountered in our emergency department. From our literature search, we found no articles regarding this disease process in the Emergency Medicine literature. We are concerned that this disease is often under appreciated and often unrecognized when it presents in the emergency department. The disease seems to be far more prevalent than we initially thought and appears to be four times as common as HSV encephalitis. While treatment for this disease process would not be initiated in the emergency department, early recognition by an emergency physician could lead to quicker diagnoses, earlier treatment, better outcomes, and the avoidance of costly misdirected work ups. Thank you for your time and consideration.