Short-chain acyl CoA deficiency (SCAD) is an autosomal recessive disorder of fatty acid beta-oxidation. Affected individuals can have variable presentations ranging from acidosis and neurological impairment to merely myopathy. Some patients may have vomiting, hypoglycemia and microcephaly. The symptoms may be triggered by viral infections and may present in adulthood. Management includes avoidance of fasting, and following a diet low in fat and high in carbohydrates. Medications include L-carnitine and Riboflavin.