A 28-year-old woman presented with a rare primary epidural hemangioma without adjacent vertebral involvement manifesting as progressive paraparesis. Magnetic resonance imaging of the thoracic spine showed an epidural lesion at T4-5 space appearing as isointense on T₁-weighted images with enhancement by contrast medium and hyperintense on T₂-weighted images. The lesion was totally removed microsurgically. Histological examination revealed cavernous hemangioma. She made a complete recovery from her symptoms and has remained asymptomatic for 9 years.