Subacute combined degeneration of the spinal cord (SCD) is a neurodegenerative disease characterized by subacute progression in the central and peripheral nervous systems mainly caused by vitamin B12 deficiency.1 In the diagnosis of vitamin B12 deficiency, measurement of urine methylmalonic acid (MMA) and serum homocysteine levels has been reported as more useful than measurement of total vitamin B12 level.2 We report a rare case of SCD that we diagnosed by determining urine MMA, serum homocysteine levels with significant neurologic symptoms and characteristic magnetic resonance imaging (MRI) findings of the spinal cord, in the absence of characteristic findings of vitamin B12 deficiency and anaemia. Informed written consent obtained and documented.