Since its discovery nearly a decade ago, the encephalitis associated with antibodies towards the N-methyl-D-aspartate receptor (NMDAR) have created a buzz in the field of neurology and other disciplines including gynaecology. Mostly affecting children and young adults, anti-NMDAR encephalitis can be associated with the presence of a tumour, commonly an ovarian teratoma. Anti-NMDAR is an identified antibody produced against neuronal cells which are found in various parts of the body and thus can also be found in teratomas. It also attacks brain tissue that subsequently results in an encephalitic clinical state. It is a multistage disease that usually presents with psychosis, behavioural changes and seizures that progresses to a state of unresponsiveness, breathing and autonomic instability. Management includes immunotherapy and tumour resection if present. We illustrate four cases of young ladies who unfortunately had encephalitis with positive anti-NMDAR. Two of the cases had no radiological evidence of any ovarian tumour, but diagnostic laparoscopy revealed small cysts and resection resulted in substantial recovery that occurred in reverse order of symptom development.