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Background: Neurofibromatosis is a disease caused by a rare genetic abnormality that causes tumors to grow on nervous tissue. It can lead to various deficits including severe pain, balance issues, hearing and vision loss, muscle atrophy, growth defects, numbness/tingling, learning disabilities, and many other changes depending on the type and severity of the disorder. There is little evidence to guide physical therapy interventions for individuals with this disorder. The purpose of this case study is to outline interventions that may be beneficial and safe for adults with neurofibromatosis affecting spinal and peripheral nervous tissue. Case description: A 55-year-old male was diagnosed with neurofibromatosis type II at the age of 11. At the age of 30 he began to manifest clinical signs and symptoms affecting his function. Since then, various benign cysts have affected nervous tissue in all limbs and impacted his hearing. Major complaints at initial evaluation included difficulty walking and performing activities of daily living without caregiver assistance. Outcomes: Over the course of 7 weeks, the patient improved his tolerance for walking, standing, and other functional tasks and decreased his fall risk based on his Tinetti balance score. Discussion: This case outlines the acute interventions and progressions used, resulting in improved functional capacity, with gains in ambulation and balance made over a 7-week interval. He made slow progress towards his other goals. This case study provides some insight into safe and potentially beneficial therapeutic interventions as well as expectations and prognosis for individuals affected by neurofibromatosis.