Cardiovascular instability is a common manifestation of spinal cord injury, especially if the upper thoracic or cervical spine is involved. Here we report a case of lower thoracic spinal tumor who developed acute pulmonary edema postoperatively at post-anesthesia room following surgery. This might be caused by injudicious fluid administration after trying to correct intraoperative hypotension due to neurogenic shock. Therefore, meticulous calculation in fluid resuscitation together with vasopressors or inotropics support is important in dealing with neurogenic shock. Comprehensive monitoring of hemodynamic parameters, such as with central venous catheter or pulmonary catheter in this sort of surgery should be established for drastic fluid management.