The Ganser syndrome was long regarded as an entity that had as its core symptom ‘giving inappropriate and/or misleading answers’ to questions. In the literature we found confusion regarding the diagnostic and etiological criteria. We describe the case of an 53-year-old male patient who displayed a number of remarkable symptoms during a delirious episode which ended when the symptoms faded. By reviewing the recent literature, we outline the evolution in the use of the symptom and syndrome diagnosis.