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A 76-year-old male patient with coexistence of factor V Leiden and hyperhomocysteinemia is reported. Since the patient had a recurrent venous thrombotic condition and factor V Leiden was positive, he was tested for other genetic risk factors. The patient’s homocysteine level was found to be elevated. There were no findings indicating presence of other genetic risk factors. Identification of genetic defects which result in an increased tendency to thrombosis has important implications for the patients and also for their families.