BackgroundJerusalem's psychiatrists expect to encounter, as the millennium approaches, an ever-increasing number of tourists who, upon arriving in Jerusalem, may suffer psychotic decompensation.AimsTo describe the Jerusalem syndrome as a unique acute psychotic state.MethodThis analysis is based on accumulated clinical experience and phenomenological data consisting of cultural and religious perspectives.ResultsThree main categories of the syndrome are identified and described, with special focus on the category pertaining to spontaneous manifestations, unconfounded by previous psychotic history or psychopathology.ConclusionsThe discrete form of the Jerusalem syndrome is related to religious excitement induced by proximity to the holy places of Jerusalem, and is indicated by seven characteristic sequential stages.