1 IntroductionSubacute combined degeneration (SCD) is a neurodegenerative demyelinating disease that affects the posterior and lateral columns of the cervical and upper dorsal parts of the spinal cord and is caused primarily by vitamin B12 deficiency. In addition to SCD, vitamin B12 deficiency produces various other neurological and psychiatric symptoms as well as a wide spectrum of hematological abnormalities [1]. Chronic vitamin B12 deficiency has been identified in the majority of patients with hyperhomocysteinaemia (HHcy), which promotes venous thrombosis and atherosclerosis via various mechanisms [2]. One such case report of a young patient demonstrated severe HHcy secondary to vitamin B12 deficiency as a cause of pulmonary embolism and myocardial infarction [3]. Although the association of deep venous thrombosis with HHcy has been well established [4, 5], its presentation with SCD is not reported in literature to our best of knowledge. The current report describes a 68 years old female who presented with SCD of the spinal cord coexisting with deep venous thrombosis (DVT).