Multiple Acyl-CoA Dehydrogenase Deficiency (MADD) or Glutaric Aciduria II (GAII) is an extremely rare disorder that can result from deficiency of the alpha or beta subunits of electron transfer flavoprotein or its dehydrgenase ETF:ubiqinone oxidoreductase (ETF-DH or ETF:QO). Defects in any of these genes may lead to a range of clinical phenotypes from mild to severe, depending upon the mutation. Three clinical phenotypes for GAII have been described. Type I presents as a life-threatening disorder during the neonatal period with tachypnea, dyspnea, profound acidosis, severe hypotonia and convulsions. Hepatomegaly, hypoketotic hypoglycaemia, hyperammonemia, sweaty-sock like odor and congenital anomalies including renal cystic dysplasia, heart abnormalities, central nervous system malformations, facial dysmorphism, rocker bottom feet, and abnormalities of the external genitalia may also be present. Type II presentation is similar to Type I without the congenital anomalies, while a Type III presentation occurs later with intermittent episodes of vomiting, hypoglycemia, and metabolic acidosis during infancy or episodic muscular weakness and pain during adulthood along with progressive myopathy. Recurrent panceatitis has also been reported with abdominal symptoms.