Abstract
Microcephalic osteodysplastic primordial dwarfism type II (MOPDII) is a rare genetic disorder characterized by severe pre- and postnatal growth failure and microcephaly. We present two male siblings with MOPDII confirmed by the identification of compound heterozygous variants in the pericentrin (PCNT) gene. The first, a twin with intrauterine growth restriction, was diagnosed postnatally at four years of age after developing dysmorphic features and neurodevelopmental delays. His younger sibling was diagnosed prenatally via chorionic villus sampling. These cases highlight that MOPDII can result from compound heterozygous inheritance and underscore the importance of considering this diagnosis in severe, symmetric intrauterine growth restriction. A structured, multidisciplinary approach is essential for managing the complex comorbidities, including the high risk of cerebrovascular disease.