Case: Male with impaired physical activity and learning difficulties first seen at age 12. At the age of 17, he was found to have no pubic hair or facial hair growth, delayed genital development, and endocrine dysfunction, and was found to have dystonia, dysphagia, dysarthria, and progressive hair loss in the left upper extremity. The dystonia and chorea-like symptoms were prominent. The parents are close relatives. The patient’s sister had similar symptoms, had learning difficulties in elementary school, had progressive gait instability at age 14, had dysarthria and hair loss, and had primary amenorrhea. Diagnosis: Woodhouse-Sakati syndrome Woodhouse-Sakati syndrome is also a rare autosomal recessive disorder, first described by Woodhouse and Sakati in 1983. The main manifestations are progressive extrapyramidal symptoms with poor gonadal development and function, baldness, deafness, diabetes mellitus, mental retardation, hearing loss, and local or generalized dystonia. T2-weighted images on MRI show pale globules, marked iron deposition in the substantia nigra and basal ganglia, and cerebral white matter degeneration. Woodhouse-Sakati syndrome is characterized by endocrine dysfunction, which is the most important differentiating point between Woodhouse-Sakati syndrome and other NBIAs.