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Objective: To identify the demographic characteristics and the etiologic causes of early onset dementia in Tunisian patients. Background Early-onset dementia is defined as dementia occurring before age 65 years. Its prevalence was estimated to 54/100.000H. It has some clinical and etiologic characterizes. Design/Methods: we conducted a retrospective study in the department of Neurology of Razi hospital (Tunisia) over a 9 years period (July 2002-September 2011). Were included demented patients in whom cognitive decline occurred before 65 years. A comprehensive methodology was used to attempt to establish a specific cause. Results: The study identified 360 cases of early onset dementia among 1325 demented patients, giving a frequency of 27.16% of dementias cases. 55 not investigated patients were excluded. Male to female ratio was 1.10. Mean age at onset was 55 years and mean age at presentation was 58.6 years. Etiologies varied with neurodegenerative causes accounting for 60.32% of the cohort. Alzheimer9s disease was frequent (39.67%). Vascular dementia accounted for 15.40%. Metabolic causes accounted for 2.29% and inflammatory causes accounted for 2.29%. At last follow-up, 13 patients (4.26%) had an unknown etiology. Conclusions: Dementia in people under the age of 65 years is uncommon when compared to the prevalence in older people. We report one of the largest cohorts of early onset dementia. It includes a broad variety of etiologies, with few patients having a potentially treatable disorder. Neurodegenerative causes and especially Alzheimer9s disease are frequent but considerably less common than in elderly people. The devastating consequences and financial loss for the patient9s family as well as society, emphasizes the importance of developing strategies for diagnosis and management of younger patients in our country. Disclosure: Dr. Belhouane has nothing to disclose. Dr. Ben Djebara has nothing to disclose. Dr. Hizem has nothing to disclose. Dr. Gargouri has nothing to disclose. Dr. Gouider has nothing to disclose.