Huntington’s disease (HD) is a neurodegenerative movement disorder that negatively impacts quality of life. Atypical antipsychotics are used for treatment, though with limited evidence from controlled trials. In this preliminary study we investigated the effects of risperidone, an atypical antipsychotic for the treatment of chorea in HD using intravoxel incoherent motion diffusion weighted imaging (IVIM-DWI) and volumetric analysis. Preliminary findings suggest that early effects of risperidone may present as changes in the microcirculation within the basal ganglia prior to any anatomical changes. However, further evaluation in a larger sample size is needed to better assess the clinical response to risperidone.