A 14-year-old girl with a unique type of progressive spondyloepiphyseal dysplasia, corneal clouding, and no evidence of neurological abnormality, was found to have a remarkable deficiency of acid p-galactosidase activity in cultured skin fibroblasts and in leucocyte preparations. In fibroblasts, ganglioside GM1 p-galactosidase activity averaged 7 % of the normal mean while asialofetuin p-galactosidase and 4-methylumbelliferyl-~-galactosidase averaged 1.4 % and 3.5 %, respectively. Activities for all three substrates in leucocytes from both her parents were close to 50 % of the normal mean indicating that the patient is homozygous for a mutation (or mutations) affecting GM1 0-galactosidase.