Neuroleptic-induced akathisia should be definitely diagnosed as acute, tardive, withdrawal, and chronic. The diagnostic assessment must be identified from the subjective report and objective features. Various assessments of measuring akathisia can be clinically used by instrumental methods and rating scales. The pharmacological basis of neuroleptic-induced akathisia is the inhibition of the dopamine receptors in the brain. The pathogenesis of neuroleptic-induced akathisia may involve GABAergic hypoactivity, noradrenergic hyperactivity, and serotonergic dysfunction in CNS. Iron deficiency and hyperglycemia may be risk factors of neuroleptic induced akathisia in relation to the dopamine function in the brain. Neurological disorders may be associated with the development of a syndrome resembling drug-induced akathisia. The lesion of the thalamic nuclei would originally produce the syndrome. The difference between acute and tardive akathisia on the strategy of the drug treatment should be sufficiently comprehended. In particular, the long-term use of anticholinergic drugs and benzodiazepines should not be prevailed.