Intramedullary epidermoid cysts of the spinal cord are rare tumors. They are slow-growing tumors. We report a case of a 74-year-old patient presenting with thoracic spinal cord compression syndrome (T11-12). The magnetic resonance imaging (MRI) showed an intramedullary cystic mass. It demonstrated low signal intensity on Ti- and high signal intensity on T2-weighted images, with minimal peripheral enhancement following intravenous gadolinium diethylene-triamine-penta-acetic-acid (Gd-DTPA) administration. After surgical removal of the tumor, the pathology confirmed the diagnosis of spinal epidermoid cyst.