Spinal angiolipomas are rare benign tumors composed of mature adipocytes mixed with abnormal vessels. They represent 0.0004 to 1.2% of angiolipomas, usually located at the extradural and posterior thoracic level, with multimetameric extension. Spinal angiolipoma is an uncommon form of benign tumor. There are 2 types: non-infiltrating and infiltrating. Its clinical course is slow and progressive, and it can be accelerated by vascular phenomena, intratumoral abscess and pregnancy. Intratumoral bleeding must be considered a cause of acute spinal compression syndrome. Spinal epidural angiolipoma is a rare, slow-growing and progressive benign tumor. MRI is the gold standard for diagnosis. The gold standard treatment must always be surgery, although total resection may not be possible in some cases.