This case suggests that long-term treatment with clozapine may be associated with tardive dyskinesia in an individual with minimal exposure to conventional antipsychotics. Since the patient had approximately 2 years of exposure to typical antipsychotics before starting to take clozapine, their contribution cannot be discounted. Given that the patient had no evidence of involuntary movements before clozapine treatment and that she received clozapine for approximately 10½ years before the onset of tardive dyskinesia, the impact of typical antipsychotics is likely to be minimal at most. It is possible that the patient’s dyskinesia would have occurred spontaneously in the absence of antipsychotic exposure, but this is unlikely. In conclusion, clozapine and the other atypical antipsychotic drugs appear to have greatly reduced the liability for tardive dyskinesia, but it appears that they have not totally eliminated the risk.