Psychotic disorders can have a primary or secondary origin. Primary psychosis includes pathologies such as paranoid schizophrenia, acute psychotic episodes, schizoaffective disorder, and other chronic psychiatric disorders. However, in secondary psychosis, there is an organic cause that explains the appearance of psychotic symptoms, such as those secondary to the consumption of psychoactive substances or some neurological or systemic diseases. Psychosis in epilepsy falls under secondary psychosis. It may present as hallucinations and delirium reminiscent of some primary psychoses such as schizophrenia. We present the case of a 57-year-old female suffering from temporal lobe epilepsy who developed psychotic symptoms and whose definitive diagnosis was a challenge given the similarities between some alternative diagnoses, mainly between interictal psychosis of epilepsy and late-onset schizophrenia. We also review the relevant literature. We consider that more studies are required to clarify the relationship between epilepsy and psychosis.