Epidural angiolipomas are rare tumours and are histologically benign, but their myelographic and macroscopic appearance is malignant. Surgical results are satisfactory. A case is reported in a 48-year-old woman with a slowly progressive cauda equina compression syndrome in whom an epidural angiolipoma was successfully removed. The special feature of this case was a generalized severe spinal osteoporosis with a pathological fracture of a vertebral body at the level of the tumour.