Cavernous hemangiomas are vascular malformations that effect the central nervous system. This pathology is frequently encountered in the cerebral hemispheres, cerebellum, and brainstem. Cavernous hemangiomas, although usually solitary, may be associated with the same lesion in other parts of the central nervous system or other organ systems and may appear as sporadic or familial cases. They are infrequently found at the spinal level; in particular, pure cervicothoracic epidural location is rare. We report a case with a purely spinal epidural cavernous hemangioma from C6 to T1 and discuss the clinical, diagnostic, and therapeutic aspect of this unusual spinal malformation.