Some of the less common, but extremely important, causes of cystic lesion within the confines of the spine are spinal cord neoplasms. The cystic component can be from within the neoplasm itself or from the syrinx cavity created by the tumor. Understanding the imaging characteristics of the lesion will aid in narrowing the differential diagnosis and will better prepare the surgeon for a successful resection at the time of surgery. Recent advances in surgical technique and surgical equipment have drastically lowered the morbidity of resection of intramedullary lesions of the spinal cord.