A 43-year-old woman with end-stage renal disease suffered from progressive left abdominal distension and pain; this was accompanied by an acute onset of bilateral lower limb weakness during her renal dialysis. Computed tomography revealed a left tubulo-ovarian abscess with compression of the sigmoid colon. Magnetic resonance imaging (MRI) revealed a T-1 to T-5 spinal cord infarction that might have been caused by septic emboli. During an MRI follow-up after three-months, a longitudinal intradural arachnoid cyst at T-5 to T-7 level of the spinal cord was discovered. Surgical intervention to remove the arachnoid cyst was performed due to increasing numbness of lower limbs and worsening orthostatic hypotension. The patient's recovery was excellent and she could walk for short distances independently eight months after the operation.