Anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis is an autoimmune disorder. Clinical presentation includes behavior, memory, motor dysfunction, psychiatric symptoms, seizure and hypoventilation. The disorder has been previously associated with ovarian teratoma which particularly females. Confirmation of anti-NMDAR encephalitis is the key to early diagnosis and prompt treatment, which may alter the course of the disease. Early tumor removal and aggressive immunotherapy is the key to improved clinical outcomes. We present the case of a 26-year-old female, with no known prior medical problems. Two days after admission, she developed fever, focal seizure, urine incontinence, psychiatric symptoms, and dyspnea. On admission to our hospital, she presented with involuntary orofacial movements and refractory status epilepticus. The patient's status epilepticus and psychotic symptoms, markedly improved following immunotherapy, high dose anti-epilepitic drugs, plasma exchange and removal teratoma.