Lithium is a well-established medication used to treat mood disorders and bipolar disorder. This paper describes the case of a 63-year-old male patient who was admitted with altered mental status secondary to lithium toxicity and subsequently developed new T-wave inversions and left axis deviation on serial EKGs. As his Lithium levels decreased to therapeutic range, the T-wave inversions spontaneously resolved and he demonstrated improvement in his mental status and neurotoxic symptoms. Lithium toxicity is commonly associated with prolonged QTc intervals and bradycardia. However, practitioners should also be aware that it can also cause EKG changes that mimic ischemic changes in the absence of elevated cardiac biomarkers. We recommend a thorough review of medications in elderly patients who present with neurologic and cardiac sequelae.