Russell-Silver Syndrome (RSS) is a rare genetic developmental disorder characterized by prenatal and postnatal growth delays and other physical abnormalities. Neuropsychological screening was completed with LP, a 20-year-old college male diagnosed at one year of age with Russell-Silver Syndrome. LP's history and test findings yielded a profile consistent with a nonverbal learning disability, with significantly higher verbal compared to nonverbal intelligence, deficient visual-spatial memory, fine motor coordination and motor planning problems, relatively greater difficulty in math compared to other achievement areas, decreased writing fluency, and social behavior impediments. LP also experienced attention and concentration problems along with a ruminative cognitive-emotional style and mild depression. His pattern of processing weaknesses indicated a need for academic accommodations to complete his college-level academic work, along with counseling to address emotional issues. Further studies of individuals with RSS should consider neuropsychological assessment to address patterns of cognitive processing and possible need for educational and psychosocial intervention.