Background: Empty Sella Syndrome (ESS) is a condition where the Sella Turcica, containing  pituitary gland, appears empty or partially empty on imaging studies. Secondary ESS can result  from various underlying conditions, one of them being Sheehan’s Syndrome. It is characterised  by the presence of a hypophyseal necrosis due to severe postpartum haemorrhage and  hypovolemic shock which rarely presents with psychotic disorders.  

Case Description: Here, we present a case of 60-year-old female presented with history of  second- and third-person auditory hallucination, delusions of reference and persecution of 25  years duration with post-partum onset secondary to Empty Sella Syndrome.  Discussion: Our case supports the role of hypothalamic-pituitary-adrenal (HPA) axis  involvementand hormonal dysfunction hypothesis in manifestation of psychosis.  Conclusion: Our case is an unusual presentation of Schizophrenia secondary to Sheehan’s  syndrome. This case brings awareness of neuropsychiatric manifestations of Empty Sella  Syndrome.