Most authorities suggest Sydenham chorea (SC) to be an autoimmune disease that is triggered by a streptococcus infection, subsequently resulting in a hypersensitivity humoral reaction to the infection and cross-reactivity streptococci antigens and human tissue antigens through antigen mimicry. Typically, the first episode occurs 6 to 8 weeks after an episode of GABHS pharyngitis. Diagnostic evaluation of Sydenham chorea should include a careful history and neurologic examination. This case presents an 11-year old girl with a primary complain of involuntary movements, slurred speech and an unstable gait since 1.5 month. Chorea is a clinical diagnosis, made after a careful assessment to exclude other causes. It is important to consider whether a child presenting with chorea could have an autoimmune disorder. Laboratory investigations and echocardiography may be indicated, particularly if there are no other features to support a diagnosis of rheumatic fever.