A case of a 17-year-old boy with a spinal epidural abscess and a history of pus in the knee, followed by paraplegia is reported. Myelography, metrizamide computed tomography myelography, and radioisotope scan were useful in the diagnosis. A laminectomy of Th10 was performed. During the operation, extension of the abscess cavity was ascertained with a contrast medium. The pus was removed completely. However, the neurological results were unsatisfactory. Pertinent literature is reviewed and the 46 cases in Japan are analyzed. The importance of early diagnosis and early operation is emphasized.