The concept of erotomania is discussed and the literature surveyed. The aim of the study is to present a long-term personal follow-up evaluation of cases with erotomania like symptoms. In a material of 1,802 consecutively admitted patients, 6 (0.3%) presented symptoms suggestive of erotomania. They have been personally followed up 2 or 3 times by the authors over a period of 22–35 years. Our sample was characterized by avoidant and/or paranoid premorbid personality traits with difficulties in establishing relationships, and lifelong social isolation. However, the overall clinical outcome was not hopeless. Neuroleptics may be of benefit, and our findings indicate the need for psychosocial treatment to increase the life quality in these patients.