We present the case of a 32-year-old white man seen for evaluation of pancytopenia 12 years after thoracolumbar myeloresection of intramedullary ependymoma. Bone marrow examination revealed extensive marrow fibrosis and tumor infiltrate compatible with metastatic ependymoma. Myelophthisic anemia due to metastatic ependymoma, though not previously reported, should be entertained in the differential workup for pancytopenia.