Paraplegia developed in a 70-year-old man after resection of a ruptured abdominal aortic aneurysm during which aortic occlusion time was 45 minutes. Between one and three months postoperatively, he progressively recovered motor function to the point where he could walk unaided. Only four patients have previously been reported to recover from paraplegia produced in this manner. A review of the literature on the anatomy of the arterial supply to the spinal cord indicates the importance of the anterior spinal artery and the artery of Adamkiewicz (arteria magna radicularis). Paraplegia is more common in patients with hypotension and when backbleeding from the lumbar arteries has been poor.