Identification of individuals with catatonic disorder secondary to a general medical condition (CD-GMC) may affect both acute and long-term patient management. The authors performed a 20-year retrospective cohort analysis of all patients meeting DSM-IV-TR criteria for catatonic subtypes seen at our institution. Encephalitis was the most common etiologic diagnosis among patients with CD-GMC, and lumbar puncture the test most likely to affect acute management. Univariate logistic-regression analysis utilizing Bonferroni correction for multiple comparisons yielded absence of a psychiatric history and history of clinical seizure as variables increasing the likelihood of a diagnosis of CD-GMC. Prospective evaluation across a larger patient series will be required to better identify patients with catatonia who would benefit from neurologic evaluation.