Music and neurology find a point of intersection in Gaetano Donizetti (1797–1848). This renowned Italian composer—creator of L’elisir d’amore (1832), Lucia di Lammermoor (1835), and more than seventy operas—presented a clinical picture consistent with neurosyphilis, a condition that shaped both his life and his creative output. This letter aims to analyze that clinical picture, highlighting its neuropsychiatric implications and its impact on musical creativity.