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We describe a case of a 21-year-old man who developed Clozapine induced myocarditis (CIM), an uncommon, but serious and potentially life threatening, side-effect of Clozapine. The case is unusual because of presentation was atypical (symptoms, age, and time frame of symptom-evolution), which increased the risk of the adverse event being missed. This report highlights the difficulties in the diagnosis of CIM in psychiatric patients with atypical presentations. A combination of unreliable history, uncertainties about risk factors and absence of consensus guidelines about the speed of Clozapine titration. Clinicians are often unaware of the risk factors for myocarditis. Currently there is no mandatory requirement of laboratory monitoring for detecting myocarditis during Clozapine titration, unlike that for detecting neutropenia. The case report throws into sharp relief the need for vigilance and high index of suspicion during Clozapine titration. A protocol is suggested for close clinical monitoring and laboratory investigations during Clozapine titration, which will increase the chances of early detection and treatment of CIM, thus reducing the risk of high mortality. [ABSTRACT FROM AUTHOR]