Marchiafava-Bignami disease(MBD) is a rare complication of chronic alcoholism characterized by symmetrical demyelination of the corpus callosum. We report a case of MBD in a Korean patient having chronic alcohol dependence. The patient exhibited mental depression, weakness of all four limbs and dysarthria. Laboratory data showed mild hyponatremia. Magnetic resonance imaging(MRI) revealed unusual symmetrical resolving lesions of the putamen in addition to the typically observed lesion of the corpus callosum. The neurologic disturbances were gradually improved with the normalization of low plasma sodium levels. Marked improvement of abnormal MRI findings was noted after thiamine supplement, though the patient still exhibited severe cognitive impairment.