Murray Valley encephalitis virus (MVEV) is a mosquito-borne virus endemic to Australia and New Guinea. Encephalitis due to MVEV is potentially devastating, and no therapeutic interventions of proven value exist. Prevention relies largely on personal protective measures against mosquito bites. We present a case of MVEV encephalitis with a favourable outcome following intensive care management and prolonged rehabilitation, and the epidemiological features of a further 21 cases notified to the health department of Australia's Northern Territory. As cases occur in travellers, and epidemics occur sporadically in south-eastern Australia, clinicians across Australia and further abroad should be familiar with the disease and its diagnosis and management.