What is known and objective Intensive chemotherapy for treatment of Burkitt s lymphoma (BL) - a high-grade lymphoproliferative disorder (LPD) - can cause neurotoxicity. An association between motor neurone disease (MND) and LPDs has previously been described, but there is a lack of recommendations available to guide management of such patients. This report aims to describe suitable management of BL in a patient with MND. Case description A 66-year-old woman with a history of MND affecting her limbs was diagnosed with bulky, extranodal, high-risk gastric BL. Standard chemotherapy is with multiple non-cross-resistant cytotoxic agents. To avoid exacerbation of neuropathy, six cycles of a modified regimen was planned, aiming to minimize exposure to the most neurotoxic agents. A PET-FDG-negative remission was obtained at 12 months, without the signs of central neurotoxicity, peripheral neuropathy or muscle weakness. What is new and conclusion High-intensity chemotherapy, minimizing known neurotoxic agents, was delivered safely and effectively in a patient with BL and pre-existing MND. More case descriptions are required to guide management decisions. This report describes a modified high-intensity chemotherapy regimen designed to minimize neurotoxicity, which was used successfully in the treatment of burkitt s lymphoma in a patient with motor neurone disease, adding to limited information in the literature.