Marchiafava-Bignami disease (MBD) is a rare complication of chronic alcoholism whose main pathology is symmetrical demyelination and necrosis of the corpus callous. The lesion may be found in hemispheric white matter, but the cortical involvement is extremely rare. We reported herein two cases of MBD with magnetic resonance (MR) findings, additional MR spectroscopy, and MR perfusion which revealed acute demyelination at the corpus callosum and symmetrical signal abnormality at cortical gray matter and hemispheric white matter.