Objective The clinical diagnosis and surgical management of intramedullary spinal cord cavernous hemangioma were discussed.Methods Forty-four patients with pathologically confirmed intraspinal cavernous hemangiomas who were underwent operation at Beijing Tiantan hospital from January of 2000 to June of 2008 were reviewed retrospectively.All the patients underwent preoperative magnetic resonance (MR)imaging and were treated with laminectomy and microsurgical resection of the malformation.Results Thepostoperative neurological status was improved in 33 patients,remained unchanged in 8,and aggravated in 3.There was no surgery-relmed deatk Conclusions Operation is the first choice for the treatment of intramedullayy cavemous hemangiomas.Dissection should he performed between tumor and gliosis during surgical procedure.The intraoperative uhrascand examination and electrophysiological monitoring techniques are helpful to protect spinal cord function.