Neuroleptic malignant syndrome (NMS) has come to be recognized as one of the most serious adverse reactions to neuroleptic therapy. Complications may include cardiopulmonary failure, rhabdomyolysis and renal failure, disseminated intravascular coagulation, infection, dehydration, and shock. This article points out the need for intensive medical management for patients with NMS and questions whether private psychiatric hospitals are adequate to the task.