We report on a 33-year-old woman who had a paraneoplastic syndrome with anti–N-methyl-d-aspartate receptor encephalitis, associated with ovarian teratomas. She presented with acute onset seizures, grandiosity, elevated mood, disorganized thoughts, and paranoia. Cerebral spinal fluid analysis revealed anti–N-methyl-d-aspartate receptor antibodies. A PET/CT was requested, which identified a possible fat and calcification containing right adnexal lesion on the noncontrast CT portion, which was suspicious for a teratoma. Subsequent ultrasound revealed bilateral masses consistent with teratomas. She underwent laparoscopic removal of these masses, which were both confirmed to be mature cystic teratomas on pathology. After surgery, her symptoms progressively improved.