Tardive dyskinesia (TD) is a movement disorder secondary to neuroleptic treatment. Whether TD is associated with neurocognitive dysfunction is a controversial issue. We reviewed 31 published studies evaluating neuropsychological (NP) test results in schizophrenic patients with and without TD and found that TD was generally reported to be associated with cognitive impairment. Numerous methodological limitations, however, restrict the conclusions made about the relationship between cognition and dyskinesia. We therefore undertook a study in which 143 schizophrenic patients were evaluated on a comprehensive NP test battery. On both global and learning deficit scores, TD patients demonstrated greater impairment than did a matched comparison group. Two aspects of TD (severity and topography) were related to severity of cognitive impairment. These findings suggest that dyskinesia and cognition may share some underlying mechanism in schizophrenia.Neuroleptic-induced tardive dyskinesia (TD), a disorder of abnormal involuntary movements, is one of the most serious iatrogenic effects of the long-term neuroleptic treatment of schizophrenia. TD is characterized by choreoathetoid or rhythmic movements involving the mouth, jaw, tongue, lips, limbs, and trunk that occur after prolonged treatment with neuroleptics (Kane et al., 1992). When TD becomes severe it involves the entire body and often resembles Huntington's chorea. The generally recommended treatment of TD is neuroleptic discontinuation, although TD frequently persists after the neuroleptic treatment is discontinued and can be irreversible. In many schizophrenic patients discontinuation of neuroleptics is not feasible, however, because of the risk of relapse or exacerbation of psychotic symptoms. Thus, there is no definitive means of prevention or treatment for TD in patients who need neu-