X-linked adrenoleukodystrophy (X-ALD) is an inherited progressive neurometabolic disease caused by mutations in the ABCD1 gene and the accumulation of very long-chain fatty acids in plasma and tissues. Heterogeneous clinical manifestations include adrenal insufficiency, myelopathy, and/or cerebral demyelination. Based on the age of onset and the extent of organs affected, X-ALD is classified into seven clinical subtypes: childhood cerebral, adolescent cerebral, adult cerebral, adrenomyeloneuropathic, cerebellar, adrenal insufficiency-only (Addison's disease), and asymptomatic or presymptomatic types. X-ALD exhibits a high variety of clinical characteristics. The clinical symptoms include progressive dysfunction of central and peripheral nervous systems, such as paralysis, behavioral disturbance, abnormalities of sphincter control, sensory loss, or paresthesia, with or without adrenal insufficiency. The authors prove that the final diagnosis is based on genetic analysis to detect the ABCD1 mutation. A case from own clinical practice is given.