Spinal epidural abscess is an uncommon and serious infection resulting from direct extension of a local process or hematogenous spread from an antecedent or ongoing distant focus of infection. The findings of spinal ache, tenderness, and fever should suggest the diagnosis, and the appearance of weakness and loss of sensation below the area of pain should be considered as the strongest possible clinical confirmation. In cases in which this constellation of findings occurs, rapid evaluation and immediate surgical decompression and drainage offer the patient a possible successful functional recovery. Even in recent series, permanent paralysis and death occur with unfortunate frequency, and these have usually been related to delay in diagnosis and definitive surgical therapy.