Contents Chorea-ballism is an abnormal involuntary movement disorder that is characterized by brief, semi-directed, irregular movements and is a rare form of neurological impairment complicated by severe hyperglycemia. Although hyperglycaemia is the most common metabolic cause of chorea-ballism, the clinical characteristics and mechanisms has not been established. The reported cases find that most sudden, hyperglycemia -induced dyskinesia occur in females between the age of 50-80 years. We report the case of a 80 year old female, who visited to our emergency department with the chief complaint of involuntary movements of both upper and lower extremities and face. The patients had a medical history of diabetes mellitus during 10 years and hypertension. Before she visit our emergency department, she was almost bedridden state for a month since she was slipped down. There was a mild elevation of BUN and LDH value, at 35.1 mg/dL and 261 IU/L in first laboratory test results. Serum glycosylated A1C and blood glucose were significantly elevated at 12.1% and 390 mg/dL. Brain MRI showed hyperintensities on T1W image and hypointensities on T2W image in the basal ganglia. There were also mild to moderate focal stenosis of left distal ICA, left proximal ICA and left distal vertebral artery, but no evidence of acute infarction. For glucose control, she was started on long acting insulin once daily, with short-acting pre-prandial insulin coverage. The neurologic symptom did not improve with adequate glycemic control, so haloperidol was started. After 3 mg of haloperidol was given orally three times a day, neurologic symptom was nearly resolved.