Marchiafava-Bignami disease is a complication of chronic ethanol intoxication. The clinical course may be acute, rapidly leading to death, or marked by a progressive dementia. A form with favorable outcome is also described. During the evolution of chronic forms, acute worsenings are possible, with subsequent partial recovery. We report a clinico-radiological case, where a first episode was followed by a good outcome. After a second episode, 3 years later, the patient developed a dementia with predominant frontal lobe signs. This case suggests that, even after a favorable outcome, a long-term poor prognosis cannot be ruled out.