Brain tumors may present with psychotic symptoms that resemble schizophrenia. Although psychosis secondary to brain tumor is relatively rare, the frequent lack of neurological findings can lead to misdiagnosis. Psychosis secondary to brain tumor is more common and also harder to accurately diagnose in the elderly. Key aspects of the epidemiology, clinical spectrum, diagnostic evaluation, and treatment are reviewed. The case of a 26-year old woman with psychosis secondary to a meningioma of the right lateral ventricle with extension into the corpus callosum and periventricular white matter is presented. Symptoms completely resolved after surgical excision of the tumor and remain in remission at 2(1/2) year follow-up on no medications. The clinician should maintain a high degree of vigilance for clinical features suggestive of this potentially reversible cause of psychosis.