Although akathisia is most commonly associated with neuroleptic medication, few cases of paroxetine-induced akathisia have been reported. A review of the authors' charts (C.F.B., A.N., S.N.G., and G.S.S.) was conducted to determine an estimated incidence for paroxetine-induced akathisia. Three cases of akathisia were reported in 67 patients treated with paroxetine. A case of akathisia secondary to paroxetine in an 18-year-old female is presented. Given the potential untoward effects of this syndrome, early diagnosis is essential. Clinical presentations and differential diagnoses are discussed.