Two teenagers with spinal cord compression due to a thoracic vertebral hemangioma are presented. Myelography showed a complete block in both patients. Selective intercostal arteriography was normal or non-conclusive. Only computed tomography (CT) gave precise information about the extent and nature of the compressive lesion. In the first case it showed angiomatous involvement of the body and all parts of the neural arch of T4, and a posterior epidural ossified angiomatous mass. In the second case it showed angiomatous involvement of the vertebral body and an anterior extradural soft tissue mass; this latter was considered to represent a resolving extradural hematoma. CT, preferably performed after intrathecal contrast injection, is the diagnostic procedure of choice for spinal hemangioma with cord involvement.