A 42-year-old male was admitted with a one year and two months history of hypesthesia below the epigastric region and gait disturbance. On examination, increased ATR and PTR were bilaterally noticed with sensory disturbance below about Th.5 dermatome level. No cutaneous manifestations were detected on his back. Plain x-ray films showed no spina bifida. Metrizamide myelography showed a space-occupying mass at the Th.5 level. At operation, an extradural tumor, severely adhesived to the dura matter, was totally removed. Histologically, the tumor was composed of fatty tissues, thin-walled vessel spaces and small vessels, diagnosed as spinal hemangiolipoma. Seventeen reported cases of spinal epidural hemangiolipoma were reviewed. Spinal epidural hemangiolipomas occur in the middle aged patients with high incidence and at the mid-thoracic level. There are two types of hemangiolipoma, namely non-infiltrating and infiltrating. In the latter case, a wide excision should be performed to include normal surrounding tissue. In women's cases, particularly during the pregnancy, the fluctuation of the symptoms occurs. The effectiveness of CT and myelography in diagnosing of spinal lipomas was discussed.