The clinical and imaging features of a paraganglioma of the cauda equina are presented. A peridural anesthesia revealed the cauda equina compression syndrome in a 68 years old man who presented first with a urinary retention. Total surgical excision of a long round-shaped encapsulated tumor was uneventful. Macroscopically this lesion filled up the spinal canal and resembled to a meningioma. It was firmly attached to the filum terminale. Adjacent large arterialized vessels visible on MRI were spared. Although the diagnosis could be evoked pre-operatively on some suggestive patterns on the MRI, the pathological findings finally confirmed the diagnosis of paraganglioma. Along with the evidence of specific light microscopic features, the use of an immunocytochemical demonstration of synaptophysine in these tumors allows a confident diagnosis to be made.