A 4-mo-old girl presentedwith complaints of two swellings, over the occipital region and dorsal region since birth. This child was born to non-consanguineous parents, at full term by vaginal delivery. Perinatal period was uneventful but mother had not taken folic acid supplements in the periconceptional period. Physical examination revealed a 3×3 cm swelling on the back of head and a 6×6 cm swelling in the mid back. Both the swellings were soft, cystic, transilluminant andwell coveredwith skin. Anterior fontanel was open and lax. Child had paraparesis with lower motor neuron type of bladder involvement. MRI revealed meningomyelocele with split cord malformation (SCM) type 1 with bony spur at D 10-11 (Figs. 1 and 2). There was an associated occipital cephalocele and chiari type 2 malformation. There was holocord syrinx and corpus callosum agenesis. The final diagnosis of this patient was cervical cephalocele, lipomeningomyelocele, SCM type I, and Chiari type 2 malformations. Multiple neural tube defects is of rare occurrence, reported to represent <1 % in all cases of neural tube defects [1–3]. The occurrence of multiple neural tube defects, like in this case, has lent credence to ‘multisite closure theory’, which has now replaced single closure ‘zipper’ theory. According to ‘multisite closure theory’, the closure of neural tube initiates at five sites and the “collision sites” of neural tube closure with