Background Kummell disease combined with huge spinal epidural hematoma is a very rare phenomenon, and its potential pathogenesis and natural course remain unclear.Case description We describe a rare case of Kummell disease with huge spinal epidural hematoma. A 75-year-old male was diagnosed with osteoporotic vertebral compression fractures and was treated conservatively. After suffering minor trauma again 8 days ago, he presented unbearable low back pain and activity restriction. Lumbar MRI showed that L1 vertebral had re-fracture and intervertebral vacuum cleft, and a huge spinal epidural hematoma extending from T12- L1. Due to the patient had no neurological deficits and unbearable low back pain, percutaneous vertebroplasty was performed, and pain was relieved significantly. The follow-up MRI showed that the hematoma almost disappeared 7 days after the operation.Conclusion Although extremely rare, there is a possibility of spinal epidural hematoma after re-fracture of Kummell disease, and it could be further confirmed via MRI and pathological examination. Timely operation is recommended, and the results are usually favorable.