Non-ketotic hyperglycemic hemichorea-hemiballismus syndrome is a rare neurological condition associated with hyperglycemia from uncontrolled diabetes mellitus. We present a case of a male patient in his late 80s with a background of T2DM who presented with a new onset of progressive involuntary movements involving the left side of his body. Imaging revealed hyperdensity in the right basal ganglia, suggestive of non-ketotic hyperglycemic hemichorea. Management included glycemic control and neuroleptic treatment, with resolution of symptoms in most cases. This case highlights the importance of considering metabolic causes of hemichorea-hemiballismus in elderly patients, glycemic control, and the correlation of these factors with quality of life.

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