Anti-NMDA-receptor encephalitis is a severe neurological disorder associated with antibodies against the NR1–NR2 subunits of the NMDA receptor. The study analyzed 100 patients with this condition, revealing that 59% had tumors, most commonly ovarian teratoma. Early tumor treatment, especially with immunotherapy, led to better outcomes and fewer neurological relapses. Patients with lower antibody titers had improved recovery. The main antibody target was in the extracellular N-terminal domain of the NR1 subunit, reducing NMDA receptor clusters on postsynaptic dendrites. These effects could be reversed by removing the antibodies. The disorder is immune-mediated, with antibodies causing excitotoxicity and synaptic dysfunction. The study highlights the importance of early diagnosis and treatment, as well as the role of tumor-associated immune responses. The disorder is often paraneoplastic, treatable, and can be diagnosed serologically. Future research should focus on immunotherapy protocols and the molecular mechanisms involved. The study also shows that patients may have persistent memory issues and slow recovery, especially if tumors are not detected or recur. The findings suggest that anti-NMDA-receptor encephalitis is a new category of immune-mediated disorder with significant clinical implications.Anti-NMDA-receptor encephalitis is a severe neurological disorder associated with antibodies against the NR1–NR2 subunits of the NMDA receptor. The study analyzed 100 patients with this condition, revealing that 59% had tumors, most commonly ovarian teratoma. Early tumor treatment, especially with immunotherapy, led to better outcomes and fewer neurological relapses. Patients with lower antibody titers had improved recovery. The main antibody target was in the extracellular N-terminal domain of the NR1 subunit, reducing NMDA receptor clusters on postsynaptic dendrites. These effects could be reversed by removing the antibodies. The disorder is immune-mediated, with antibodies causing excitotoxicity and synaptic dysfunction. The study highlights the importance of early diagnosis and treatment, as well as the role of tumor-associated immune responses. The disorder is often paraneoplastic, treatable, and can be diagnosed serologically. Future research should focus on immunotherapy protocols and the molecular mechanisms involved. The study also shows that patients may have persistent memory issues and slow recovery, especially if tumors are not detected or recur. The findings suggest that anti-NMDA-receptor encephalitis is a new category of immune-mediated disorder with significant clinical implications.