Background: Early-onset Alzheimer's disease (EOAD) constitutes 1-2% of all Alzheimer's cases, presenting with poorer prognosis, progressive symptoms, and reduced life expectancy compared to late-onset Alzheimer’s, thereby increasing socioeconomic burden. Elevated plasma homocysteine levels due to MTHFR gene polymorphisms are implicated in Alzheimer's etiology. The present study aims to explore the association between MTHFR gene polymorphisms in Sudanese population. Methods: Seventy-three EOAD patients were assessed for MTHFR C677T and A1298C polymorphisms, alongside plasma homocysteine levels. Results: Significant associations were observed between CT and TT alleles, elevated plasma homocysteine levels, and EOAD. Conclusion: MTHFR C677T polymorphism was associated in EOAD in Sudanese population. Elevated plasma homocysteine levels might frame this association and potentially contribute to the disease onset before the age of 65.