Spinal epidural lipomatosis (SEL) is an occupying lesion caused by excessive accumulation of extra-epidural fat in the ver- tebral canal, which mainly involving the thoracic lumbar canals. Clinically, it is rare condition, might present no obvious symptoms, or neu- rological symptoms in some extent, such as back pain, numbness, weakness of the lower extremities or abnormal reflexes. We have treated a SEL patient recently, now we report it and review the relevant literatures to introduce the pathogenesis, diagnosis, and treatment of SEL.