Dystonic syndromes can be divided into primary and secondary forms. Diagnosis of secondary dystonic syndromes can be challenging as causes are multifold. They include brain lesions of various origins, metabolic disease, neurodegenerative conditions, or following exposure to drugs or toxins. However, characteristic investigational findings may be directive in the diagnostic process and facilitate making the correct diagnosis and thus allow initiating the ideal treatment. In this article, we point out some clinical clues and syndromic associations which may be helpful in the approach to a patient with dystonia.