Acute spinal epidural and subdural hematomas are rare entities. The clinical presentation is similar in both cases. MR imaging is the most appropriate imaging technique. On axial images, epidural hematoma has a biconvex shape. It is separated from the spinal cord by the hypointense dura on T2-weighted images. Conversely, subdural hematoma has a crescentic shape on axial images and is located medially to the dura. In the latter case, the epidural fat is not involved. There is no surgical indication for patients with early and rapid regressive symptoms. In other cases the surgical treatment consists of hematoma evacuation.