The c.141_144del (p.Glu48LeufsTer24) variant in MTM1 is a deletion variant predicted to cause a premature stop codon in biologically-relevant-exon 4/15 leading to nonsense mediated decay in a gene in which loss-of-function is an established disease mechanism (PVS1). This variant is absent from gnomAD v4.1.0 (PM2_Supporting). The c.141_144del variant has been identified in at least 6 male probands with severe centronuclear myopathy, one of which was de novo with unconfirmed parental relationships, and one severely affected female (PMIDs: 9285787, 30241883, 33062893, 33164942, 10063835) (PS4, PM6). Additionally, the variant segregated with disease in an uncle and a male sibling from two separate families (PMID: 9285787) (PP1). At least one patient with this variant displayed a muscle biopsy consistent with centronuclear myopathy (PMID:33164942) (PP4). In summary, this variant meets the criteria to be classified as pathogenic for X-linked centronuclear myopathy based on the ACMG/AMP criteria applied, as specified by the ClinGen Congenital Myopathies VCEP: PVS1, PS4, PM6, PM2_Supporting, PP1, PP4. (ClinGen Congenital Myopathies VCEP specifications version 1; 8/7/2024)