Objective To evaluate the appearances of intraspinal dermoid ruptured into the central spinal canal, as well as the MRI diagnosis and differential diagnosis. Methods Eleven cases of intraspinal dermoid raptured into the central spinal canal were reviewed. Six cases underwent whole spine MRI scan, 2 cases with thoracic and lumbar spine MRI, as well as 3 cases only with lumbar spine MRI. Results Free fat droplets within spinal cord central canal demonstrated high signal intensity on T1 WI, slight declined signal intensity on T2WI, and extremely low signal on fat suppression sequence. Of the 11 cases, 2 cases broke into neighboring central spinal canal of the dermoid, 3 cases scattered within thoracic spinal cord central canal, 4 cases discontinuously distributed in the whole spinal cord central canal, 2 cases showed continuous distribution. Conclusion Intraspinal dermoid ruptured in the central spinal canal had specific appearance on MRI, when a dermoid tumor is suspected, MRI of the entire spine were recommended to detect possible leakage of fat within central spinal canal.