ObjectivesWe report on a patient with a distinct clinical and neuroradiologic phenotype and a de novo variant in the FTH1 gene. MethodsThe patient was a 25-year-old woman with developmental delay and pontocerebellar hypoplasia, who after years of stable condition visited our hospital at age 20 years because of clinical deterioration. With consent from the patients’ family, we obtained clinical, imaging, and genetic data from the patient’s medical record.