Carbamoyl Phosphate Synthetase I Deficiency (CPSID) is a rare autosomal recessive disorder that is strictly limited to the liver and intestine, and results in congenital hyperammonemia and defective citrulline synthesis. The management of CPSID may include a strict lifelong diet of very limited protein intake, citrulline and arginine supplementation, and administration of both sodium benzoate and sodium phenylbutyrate.