Paroxysmal movements in childhood can be epileptic and non-epileptic. Non-epileptic events comprise a wide range of disease entities. It can be challenging for a clinician to make an accurate diagnosis. This review article will focus on the clinical approach to various non-epileptic paroxysmal movements in childhood with particular emphasis on detailed history taking and examination of the abnormal events. Prompt diagnosis is extremely important for commencement of appropriate treatment if indicated and to avoid unnecessary use of medications including anticonvulsants in certain benign non-epileptic self-limiting conditions. Timely parental counselling is also important to reduce unnecessary anxiety.