Spinal vascular diseases are rare diagnostic entities but important differential diagnoses for patients presenting with myelopathy. The spinal cord is supplied by the anterior and posterior spinal arteries, reinforced by multiple segmental arteries at variable levels. Ischemic diseases cause cord infarction. Spinal vascular malformations can result in cord edema or hemorrhage. MRI/MRA is the noninvasive diagnostic modality of choice, while DSA remains the reference standard for characterizing the spinal vascular malformations.