A pilot case-control study was conducted to identify possible risk factors for Meige's syndrome. Patients with Meige's syndrome and age- and sex-matched controls suffering from other neurological diseases were recruited from the Movement Disorders Clinic and Neurology Outpatient Department of the All India Insititute of Medical Sciences. All participants were interviewed and information regarding psychiatric and medical illnesses, use of medications, exposure to fumes, dust and pets, characteristics such as marital status, socio-economic status, alcohol, tea/coffee use, tobacco use, betel nut chewing and family history of neurodegenerative diseases among first-degree relatives was ascertained. We found that betel nut with tobacco chewing was a significant predictor for Meige's syndrome (adjusted odds ratio 7.4, 95% confidence interval = 1.0-59. 82). The role of local irritation or the effect of some chemicals in tobacco and betel nuts needs further evaluation of the pathogenesis of Meige's syndrome.