Spinal epidural abscess (SEA) is rare, especially in children, in which fewer than 90 cases have been reported. We present three case examples illustrating the complex course before diagnosis and treatment. All patients had back pain, but two had pain of the abdomen or extremity dominating the clinical picture. Magnetic resonance imaging (MRI) was found to be the best diagnostic test. All had surgery with full recovery. A literature review of 58 cases since 1945 was done and showed that 76% of children had neurological compromise before surgery, and the overall mortality rate in children was 12%.