Thyroid hormones are essential for normal brain development and function, also regulating some processes in immune system. The vicious effect of hypothyroidism for central nervous system displayed in myxoedema is known for many decades, but there is a CNS disorder related to autoimmune thyroid disease and not merely dependent on hypothyroidism. That is Hashimoto’s encephalopathy (steroid-responsive encephalopathy of autoimmune thyroid-itis) — an enigmatic combination of cognitive, mood and motor disorders with psychotic symptoms, which pathogenesis is still unclear. The article describes natural history of this entity, its epidemiology, clinical and laboratory manifestation, and compares several existing theories of its pathogenesis with appropriate pros and contras. Vascular, dyshormonal and non-vascular autoimmune links of Hashimoto’s encephalopathy pathogenesis are discussed in intermingled discourse. The attempt to construct a synthetic concept of Hashimoto’s en-cephalopathy pathogenesis is given. The experience of authors based on investigation of clini-cal, endocrine and immunological parameters of 17 cases of autoimmune thyroiditis with schizophrenia-like manifestations is described, correlations are explored between immuno-endocrine and psychic manifestations of disease.