Objective To investigate the clinical features, diagnosis, and therapeutic strategies of relapsing anti-N-methyl-D-aspartate receptor (NMDAR) encephalitis. Methods A retrospective analysis was performed on 10 relapsing patients from 57 patients with anti-NMDAR encephalitis who were diagnosed and treated in the People's Hospital of Zhengzhou University from May 2013 to February 2017 to investigate their clinical symptoms, laboratory examinations, radiological features, and immunotherapy.Results In the 10 relapsing patients, there were 5 males and 5 females, with a mean age of 27.5 years. Totally, 14 relapses occurred in the 10 cases, with 2-3 relapses in 2 cases, and the mean interval between two relapses was 7.1 months (1-19 months). The clinical symptoms of the relapses were epilepsy (8/14), mental and behavioral disorders (8/14), and atypical relapsing symptoms such as dizziness, ataxia, and diplopia (1/14). Anti-NMDAR detection was performed in the relapsing patients (13 relapses). The positive detection rate was 100% (13/13) for cerebrospinal fluid samples and 69% (9/13) for serum samples. Immunotherapy was effective for the 13 relapses, and was refused by 1 relapsing case. These 10 patients underwent a follow up of mean 18.9 months, with complete recovery in 3 cases, mild sequelae in 4 cases, and severe sequelae in 3 cases.Conclusions Both typical and atypical symptoms are found when relapse occurs in patients with anti-NMDAR encephalitis. Test for anti-NMDAR antibody may help to make an early diagnosis. An active immunotherapy strategy may lead to a better prognosis.