A 57-year-old patient diagnosed with panhypopituitarism, chronically managed with steroids, developed a dorsal lipomatosis combined with multiple vertebral fractures, leading to progressive dorsal myelopathy. Surgical management was necessary, and the follow-up showed significant improvements in symptoms and quality of life. Conclusion: Spinal epidural lipomatosis is a condition resulting from excessive fat deposit in epidural space. Patients can be asymptomatic or complain from myelopathic or radicular symptoms. Many etiologies are possible and exogenous steroids excess is one of the most frequent, having a predilection for male sex and thoracic spine. Surgical management is frequently necessary and may provide good results.