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Background: Myelomeningocele, a type of spina bifida, is a prevalent birth defect that affects numerous individuals around the world. Significant research has been conducted to examine the influence of this condition on adolescents and adults, but limited evidence is available on how spina bifida influences development in childhood. Purpose/Case Description: The purpose of this report is to describe the development of motor milestones in a 27-month old female with L4-5 myelomeningocele to improve the current understanding of the expected prognosis for development of early motor milestones in children with spina bifida, specifically the diagnosis of lower lumbar myelomeningocele. Although the patient was progressing in her achievement of motor milestones, she was significantly delayed compared to her peers. Outcomes: The primary outcomes utilized in this case were tests and measures, largely qualitative, analyzing the patient’s functional mobility. Additional outcome measures that could have been incorporated include the Bayley Scale of Infant and Toddler Development and the PEDI-CAT. Discussion: The patient with L4-5 myelomeningocele was achieving motor skills consistent with those around 10-12 months of age although her chronological age at the end of the nine-week time period was 29 months. The patient was steadily progressing in the development of new motor milestones over this time and, although behind peers without spina bifida, is expected to continue making progress. This case contributes to the current understanding of expected prognosis for motor skill development in children to assist physical therapists and other providers to establish an appropriate prognosis for timing of motor skill development in pediatric patients with myelomeningocele.