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Tardive akathisia is characterized by feelings of restlessness, discomfort, and tension causing the patient to be unable to settle down and sit still. The patient should also be taking a long term antipsychotic medication without any recent changes in dosage or type, and no withdrawal of antiakathisic drugs. Aripiprazole is a potent partial agonist that shows high affinity binding to dopamine (D2) and serotonin (5HT1a) receptors and is an antagonist at 5HT2a, 5HT2b receptors. Although there are a number of case reports about arippiprazole causing acute akathisia, only one tardive akathisia case, who was a nonpsychotic female patient, has been reported so far. In this case tardive akathisia with aripiprazole developed in a patient who had diagnoses of mental retardation and psychotic disorder not otherwise specified and who was treated by supplementary drugs without stopping aripiprazole.