3-Methylcrotonylglycinuria (3MCC) is an autosomal recessive inborn error of leucine metabolism caused by the deficiency of 3-methylcrotonyl-CoA carboxylase. Patients are often identified through newborn screening. Mildly affected or asymptomatic mothers with 3MCC deficiency have also been identified through positive newborn screening in their children. The presentation of this disorder is highly variable with severe cases experiencing significant neurological abnormalities, psychomotor retardation, seizures, cardio-respiratory failure and coma. Ketoacidosis, hypoglycemia and hyperammonemia are often seen. Mild cases may be asymptomatic or display fatigue, muscle weakness and/or mild developmental delay. 3MCC can be caused by a mutation in either the gene coding the alpha subunit (MCCC1) or the beta subunit (MCCC2) of the enzyme.