Antibody-related encephalitis refers to an autoimmune inflammatory brain disease associated with antibodies against neuronal cell-surface or intracellular antigens, which takes neuropsychiatric symptoms as the main clinical manifestations. According to the antigen location, the pathogenicity of antibody and the response to immunotherapy, antibody-related encephalitis can be roughly divided into autoimmune encephalitis (AE) and paraneoplastic syndrome (PS). This review highlights the immunological pathogenesis of antibody-related encephalitis, including the causes of onset, failure of immunologic tolerance, the generation and damaging effects of pathogenic antibodies, and the destruction of blood-brain barrier, and aims to further understand the differences in pathogenesis treatment principles between AE and PS to provide evidences for further treatment optimization.