Neuroleptic malignant syndrome(NMS) is a lethal idiosyncratic reaction characterized by fever, rigidity, altered sensorium and autonomic disturbances. Antidopaminergic drugs such as haloperidol, dopamine depletors like reserpine and atypical antipsychotics such as risperidone, are the major drugs implicated in NMS. Levosulpiride belongs to the benzamide class of antiemetics and is a blocker of dopamine(D2) receptors. The drug is available in India, Korea and some European countries. Here we present an interesting case of Levosulpiride associated neuroleptic malignant syndrome in an elderly female. The case also reflects how a minor difference in the brand names can produce a major debilitating cascade in geriatric patients.