Reye's syndrome (RS), originally known by the more descriptive name ''encephalopathy With fatty degeneration of the viscera,'' was first described in children and is still seen mostly in them. However, there have been a few case reports of adult Reye's Syndrome (ARS) since the mid-1970s. The following report is a case of ARS in a previously healthy 26-year-old woman. Although the clinical description and the pathophysiology are well known in RS, the etiology and the pathogenesis are still far from clear. From available evidence a multifactorial cause seems likely, encompassing genetic susceptibility, environmental factors, and the convincing role of aspirin. Moreover, as there is increasing awareness of metabolic mimics, questions arise about the validity of some of the diagnoses of RS, even in Reye's original cases.