Background: The factors associated with anti‐N‐methyl‐D‐aspartate (NMDA) receptor encephalitis relapse are yet to be elucidated. Aims of the Study: To investigate the factors associated with relapse and prognosis of anti‐NMDA receptor encephalitis. Methods: This retrospective study included patients diagnosed with anti‐NMDA receptor encephalitis admitted to the First Affiliated Hospital of Zhengzhou University from January 2013 to October 2019. The clinical features, auxiliary examinations, treatment regimens, and follow‐up were recorded. The outcomes were relapse and 2‐year disease prognosis. Results: A total of 160 patients were included. Consequently, 6 (5%) deaths, 34 (25.4%) relapses, and 19 (15.2%) patients had a poor prognosis (modified Rankin score (mRS) ≥3) were recorded. The multivariable analyses showed that age (p =.011), abnormal magnetic resonance imaging (MRI) (p =.019), glucocorticoid pulse (p =.009), and intracranial pressure (p =.023) were independently associated with the relapse, while age (p =.030) and central hypoventilation (p =.020) were independently associated with a poor prognosis at 2 years. Conclusion: Glucocorticoid pulse therapy reduces the relapse of anti‐NMDA receptor encephalitis. Age, abnormal MRI, and intracranial pressure are risk factors for relapse, while age and central hypoventilation are independently associated with poor prognosis. [ABSTRACT FROM AUTHOR]