Idiopathic spinal epidural lipomatosis rarely is found (8 reported cases) in the absence of steroid treatment or obvious endocrinopathy, One additional symptomatic case with gait difficulty is described here. The only common etiologic factor for all cases is their obesity. Magnetic resonance imaging is the most helpful diagnostic means and should be used initially, In a patient with radicular pain or progressive paralysis who is obese, spinal epidural lipomatosis may be the etiologic factor involved.