Paraneoplastic neurological syndromes are a group of neurological syndromes secondary to an underlying malignancy. Associated autoantibodies can be classified according to the cellular localization of the antigen target. Onconeuronal autoantibodies (targeting intracellular antigens) strongly associate with cancer and the response to immunotherapy is often disappointing. Identifying and treating the underlying malignancy is a high priority. However, immunomodulation can provide a favourable outcome for neurological symptoms associated with autoantibodies specific for cell membrane antigens. An early recognition of these disorders following the triad "clinical neurological syndrome--specific autoantibodies--tumour research" is important so that patients can benefit from appropriate targeted treatments.