Pompe disease is a progressive, life-threatening genetic neuromuscular disorder. Late-onset Pompe disease (LOPD), affecting individuals over one year old, leads to trunk and proximal muscle weakness, often impacting mobility, respiratory function, and daily activities like climbing stairs or reaching overhead. Scapular winging and difficulty raising arms are hallmark signs. Diagnosis is often delayed due to symptom overlap with other disorders. Patients like Susan, Brian, Karen, and Robert exhibit varying severity, from significant limitations to being asymptomatic. Early recognition of muscle weakness or shortness of breath is crucial. Consider GAA enzyme assays or genetic testing for accurate diagnosis.