On exploration, it was revealed that the patient’s paternal grandfather, paternal uncle, paternal aunt, and younger brother also had history of VHL disease and suspiciousness toward their spouses. Initial evaluation revealed that he remained agitated and insisted that his mother stay by his side throughout. In addition to pancreatic and renal cysts on ultrasonography of abdomen, MRI of brain showed cerebellar and retinal hemangioblastomas, with two new angioblastomas. All investigations (blood sugar, liver function, kidney function, serum electrolytes, lipid profile, thyroid function, chest X-ray, ECG, and EEG) were grossly within normal limits. Mini-Mental State Exam (MMSE) score was 30/30. On serial mental state examinations, the patient expressed delusions of infidelity against his wife, which started after marriage. This led to frequent altercations between the patient and his wife within the ward setting, as well. A diagnosis of organic delusional disorder (ICD-10) was entertained because of the chance association of brain lesions of VHL disease.