This article explained why the biased-meaning symptom of social accountability practice occurs in Kelurahan Development Fund (thereafter called DPK) management, despite its management procedure through budgeting democratization process and participatory public budgeting. Development fund management by kelurahan (administrative village) and society was a manifestation of social accountability given by Surakarta City government. Its procedure was based on democratic elements including society representation, discussion to make decision and community group of village areas as beneficiary. The analysis on case study showed that civil society as the strength of social accountability enforcer was vulnerable to pathological contamination. Behind the apparently democratic procedure, the author found some things biased from substantive democratic value. The bias found in this study pertained to the elitist role composed of community representative. Another form was patron-client embryo incubation between community activist and government. Those two bias forms attenuated the accountee?s social power among active citizens. Biased function symptom resulting in the abuse of social accountability substance value is called social accountability pathology. This pathological symptom occurred due to democratic process contaminated by co-modified culture. In this context, the exchange of power had occurred as commodity. This pathology impacted on the society?s decreased trust in the active role of citizens and attenuated the public?s awareness of public problems. Keywords: social accountability, public budgeting, pathology