To analyze the clinical, electrophysiological and imaging features of subacute combined degeneration of spinal cord. Methods: A retrospective study was performed on the clinical data of 107 inpatients with subacute combined degeneration of spinal cord in which clinical, electrophysiological, and imaging features were summed up and analyzed. Results: The age of onset was 21~87 years, and male patients significantly outnumber female patients (P<0.05). Instability in gait was the most common clinical manifestation (76.6%) followed by numbness and/or weakness in both lower limbs (47.7%) and numbness and/or weakness in the extremities (29.0%). Among the concomitant symptoms, the most common was dizziness (19.6%) followed by urinary disturbance (9.3%), and vision loss and decreased responsiveness were also observed. Detection rate of megaloblastic anemia was significantly higher than that of serum VitB12 concentration decrease (P=0.041), and the degree of coincidence was medium (Kappa=0.512). Increased serum homocysteine concentration yielded a more significantly higher detection rate than that of megaloblastic anemia (P=0.00); the degree of coincidence was medium (Kappa=0.567). The positive detection rate of MRI findings of the spinal cord and brain was 56.1%. The lesions were prone to occurring at the C2~C7 and T1~T4 segments of the spinal cord. Positive detection rate of electrophysiology was 79.8% (75/94), including 47 cases of spinal cord disease complicated with peripheral neuropathy and 25 cases with peripheral neuropathy alone. Conclusion: The clinical manifestations of subacute combined degeneration of spinal cord are complex. Serum vitamin B12 concentration may conceal the condition while a high level of homocysteine may offer a more significant role in detection; changes in blood concentration of both elements often do not parallel megaloblastic anemia at different stages of the disease.