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This report discusses the clinical presentation, possible etiology, pathogenesis and treatment of two cases of NMS that occurred in elderly patients after taking atypical antipsychotics. With the increasing use of atypical antipsychotic medication in elderly patients — who may be more susceptible to this adverse reaction — there is a need to increase clinical vigilance about this condition, particularly among internists and gerontologists who may be unfamiliar with this rare complication to antipsychotic medication. An year-old male was found unconscious in his home by family members and taken to the emergency department of a general hospital. On admission he was comatose with equal pupils 1mm in diameter, a slow light-reflex, and no reaction to orbital pressure. The patient's lips were slightly cyanotic and he had sobbing-like breathing, but there were no other abnormalities found on clinical exam of the heart and lungs. His neck was supple and his abdomen was soft.