Chorea, hemichorea, hemiballismus and other parkinsonian movement disorders have been described in type 1 diabetic patient with uncontrolled hyperglycemia. In comparison, abnormal movements in diabetic ketoacidosis are rare though ketosis due to other causes can cause parkinsonism-like movement disorders. We report two cases of diabetic ketoacidosis where hemifacial spasm was the predominant clinical manifestation for which no organic cause could be detected with relevant investigations. The symptoms subsided with conventional therapy for diabetic ketoacidosis and never recurred.