Paraneoplastic limbic encephalopathy (PLE) is a remote, nonmetastatic complication of carcinoma. Neuropsychiatric symptoms consists of cognitive, affective, and behavioral changes that can predate the diagnosis of carcinoma by as much as 6 years. The most striking feature is the development of an amnestic syndrome without generalized intellectual decline. We report a case of PLE, including neuropsychological test results, and review the features of similar cases in the literature. The postulated causes and clinical implications of PLE are discussed.