In the present report we describe a complex chromosomal rearrangement, resulting in a distal 11p monosomy, in a 7-month-old severely retarded girl with a non-specific phenotype. In this complex chromosomal rearrangement chromosomes 11, 13 and 21 are involved in the translocation of the long arm of chromosome 21 on the short arm of chromosome 13 and translocation of the short arm and satellites of chromosome 21 on the short arm of chromosome 11.