Mucopolysaccharidosis VI (MPSVI) or Maroteaux-Lamy syndrome is a lysosomal storage disorder with a wide spectrum of features ranging from a severe, rapidly progressing form to a relatively mild, slowly progressing form. Symptoms can include short stature, skeletal deformities, stiff and contracted joints, hepatosplenomegaly, coarse facial features, respiratory difficulties, hearing loss, corneal clouding, and cardiac abnormalities. Neurological development is generally normal. The rapidly progressing form is characterized by onset before 2 or 3 years, impaired mobility by 10 years, delayed puberty, an adult height less than 120 cm, cervical spinal cord compression, respiratory insufficiency, surgical complications and frequently death in the 2nd or 3rd decade due to heart failure. The slowly progressing form is characterized by later onset of symptoms with a diagnosis being made after 5 years of age; however, some patients are not diagnosed until the 2nd or 3rd decades. These patients may also develop skeletal complications including carpal tunnel syndrome, joint disease and a decrease in their overall functional status, and most will develop more serious complications of MPSVI at some point including joint degeneration, cardiac valve disease, sleep apnea, decreases in pulmonary function and reduced endurance. Birth prevalence estimates for MPS VI range from 0.5 to 4.3 per million live births, with the exception of a very high rate in Turkish immigrants in Germany (2.3 per 105 live births).