Two patients with a non-traumatic hematomyelia at T9 and C3-C7 respectively, are presented. Both patients presented with pain and a Brown-Sequard syndrome. The preoperative diagnosis was made by magnetic resonance imaging, while myelography and computerized tomography were not helpful. Surgical evacuation of the hematomas and in one patient removal of a vascular malformation were performed. The neurological symptoms and signs, after a temporary worsening, progressively improved. The prompt surgical treatment of this entity and the usefulness of magnetic resonance imaging in the preoperative diagnosis and on the planning of the surgical strategy is particularly emphasized.