Objective: Thalidomide is associated with birth defects that resulted in missing or abnormal limbs, feet or hands, heart and kidney problems, spinal cord defects, and other disorders. As these individuals age they may present with complicating issues such as cerebral vascular accidents and life factors which can exacerbate existing difficulties as well as cognitive issues. This case study examines the potential influence of thalidomide defects exacerbated by acute infarction and lifestyle factors. Method: This current research involved a fifty-nine-year-old male with a history of in vitro exposure to thalidomide resulting in agenesis of the left hand and the posterior aspect of the corpus collosum. Based on computerized tomography image, the individual experienced an acute infarction of the left cerebellum. As an inpatient rehabilitation program, he participated in a neuropsychological assessment which included: Neuropsychological Assessment Battery-Memory Module (NAB), the Wechsler Adult Intelligence Scale-IV (WAIS-IV), and the Trails B. Results: Memory impairment was mild as supported by participant's performance on the NAB. Participant's performance on the WAIS-IV Processing Speed Index indicated abilities in the borderline range. Executive functioning ability presented as impaired based on participant's performance on the Trails B. Founded on results of the neuropsychological assessment, a diagnosis of Mild Neurocognitive Disorder due to Multiple Etiologies was given. Conclusion: Thalidomide was found to produce birth defects in thousands of children only recently are we noting the long-term effects on individuals as they age. Thalidomide exposure exacerbated by CVA and lifestyle factors suggests the need for follow up across the lifespan to monitor its potential long-term effects.