In an emergency setting, there are many neurologic conditions that present with psychiatric and behavioral symptoms. These symptoms may be either the first manifestation of the neurologic illness or a later occurrence in the progression of the disease. It is important that clinicians evaluating patients who have psychiatric symptoms be able to identify the signs that indicate associated neurologic illness. Moreover, they need to have strategies for managing the acute, potentially dangerous, neuropsychiatric manifestations of the disease. This chapter addresses the emergency evaluation and management of some of the common psychiatric and behavioral problems encountered by neurologists.