An unusual case of symptomatic thoracic vertebral hemangioma involving two contiguous vertebrae but confined to the posterior elements is presented. The lesion displaced and compressed the cord. The diagnosis was not considered prior to biopsy. There was uncontrolled bleeding at biopsy. Only partial surgical resection was performed, with incomplete relief of motor weakness after initial surgery. The patient refused further surgical resection. Motor power was gradually recovered after a course of postoperative radiotherapy.