A spinal epidural abscess threatens the spinal cord or cauda equina by compression and also by vascular compromise. If untreated, an expanding suppurative infection in the spinal epidural space impinges on the spinal cord, producing sensory symptoms and signs, motor dysfunction, and, ultimately, paralysis and death. Intervention early in the course of the disease undoubtedly improves the outcome. Frequently, diagnosis is understandably delayed because the initial presentation may be only nonspecific back pain. One half of cases are estimated to be misdiagnosed or have a delayed diagnosis. At times, radicular symptoms may lead to a chief complaint of chest pain or abdominal pain, mimicking a myocardial infarction or an acute abdomen.