Background: Nondysraphic intramedullary lipomas (NILs) are exceptionally rare,representing a minute fraction of primary spinal cord lesions that occur within an intact spinal column, often clinically mimicking more common myelopathies. Case Description: We present the case of a 35- year old patient exhibit ing subacute neurological decline. Diagnostic imaging confirmed a fatty intramedullary mass. Management involved microsurgical decompression and subtotal resection, prioritizing the preservation of neural integrity over radical excision.