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During autoimmune neurology practice over 20 months, we prospectively identified four patients with likely antibody\u2010mediated neurological diseases after checkpoint inhibitors: longitudinally extensive transverse myelitis, Guillain\u2013Barr\u00e9 syndrome, and myasthenia gravis. All patients shared three characteristics: symptoms commenced 4 weeks after drug administration, responses to conventional immunotherapies were excellent, and autoantibodies traditionally associated with their syndrome were absent. However, serum immunoglobulins from the myelitis and Guillain\u2013Barr\u00e9 syndrome patients showed novel patterns of tissue reactivity. Vigilance is required for antibody\u2010mediated neurology after checkpoint inhibitor administration. 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