Reflex sympathetic dystrophy (RSD) is characterized by severe pain, swelling, autonomic dysfunction and usually affects extremities following trauma. In this case we report a 16-year-old female patient who had undergone several operations on the distal of the right lower extremity over a period of 1.5 years. During the follow-up she was determined to have adolescent osteomalacia ( primary vitamin D deficiency) and RSD findings at the right lower extremity. We also examined reports in the literature concerning the probable initiator role of vitamin D deficiency among the mechanisms of RSD occurrence. This is the first report of primary vitamin D deficiency accompanied by RSD in an adolescent with multiple fractures.