Systemic hemangiomatosis is extremely rare in adolescents and adults. The authors describe a 37-year-old man with a history of hepatic, splenic, cerebral, and multiple recurring osseous hemangiomas since age 14. After a 9-year period without disease progression, the patient presented with an acute bilateral lower extremity myelopathy. This was secondary to a T11 vertebral hemangioma that compressed the spinal cord. A 2-week course of radiation therapy failed to alleviate the patient's symptoms. Successful T11 vertebrectomy was then performed to decompress the spinal cord. The many organs and serially involved bones may represent a distinct variant of hemangiomatosis not previously described in the literature.