Spinal epidural lipomatosis (SEL) is a rare complication of iatrogenic Cushing's syndrome (CS). There is only one case reported of symptomatic SEL in association with endogenous CS. We present a patient with compressive myeloradiculopathy due to SEL and Cushing's disease and suggest that in SEL of hypercortisolism, the excess of corticosteroids is the stimulus for the growth of adipose tissue in the spinal canal and that treatment should be aimed at correcting the endocrine abnormality.