Chorea is characterized by involuntary, fidgety, dance-like movements caused by basal ganglia lesions. It has frequently been reported with hyperglycemia in diabetic patients, but not in association with hypoglycemia. We report on a diabetic male on hemodialysis who developed recurrent, acute, reversible choreiform movements associated with repeat episodes of hypoglycemia. Imaging was able to capture brain lesions corresponding to the acute episodes and the resolution of lesions between acute episodes.