During the archaeological excavations of a Christian monastic cemetery in northern Sudan, a double-vaulted tomb was discovered housing the remains of three individuals, among them a 50+-year-old female. The skeletal remains of this individual displayed significant asymmetry of the lower limbs, with apparent muscle atrophy and shortening of the left extremity, in combination with other symptoms suggestive of a neurogenic background of the condition. This paper presents a differential assessment, considering various possible etiologies of the observed lesions, including poliomyelitis, cerebral palsy, and Rasmussen's encephalitis. The morphology and patterning of the observed lesions suggest the first known occurrence of poliomyelitis from medieval Sudanese contexts.