Delusional misidentification syndromes (DMS) are rare neuropsychiatric syndromes. Most of the available data on DMS is from the developed countries. The present retrospective analysis was conducted on patients utilizing the psychiatry services in a North Indian tertiary care hospital. Out of the 2596 treatment records that were screened, DMS was seen in 20 (0.77 %) patients. Majority of the patients exhibiting the phenomenon in patients diagnosed with schizophrenia (N = 13) and schizoaffective disorder (N = 3). Females (N = 14) outnumbered males (N = 6), and the most common DMS noted was Capgras syndrome. The study found that 12 out of 16 patients with schizophrenia or schizoaffective disorder with DMS had treatment-resistance, necessitating the use of clozapine, with 4 patients also requiring electroconvulsive therapy. The study highlights the fact that DMS is a rare neuropsychiatric syndrome seen in patients with schizophrenia and schizoaffective disorder, and respond poorly to conventional antipsychotics.