Case Presentation: We describe a case of a 57-year-old male with multiple medical comorbidities who presented to the emergency department with a two-week history of upper back pain with associated numbness. Physical exam demonstrated sensory loss in a bilateral third and fourth thoracic dermatome distribution. The diagnosis of spinal arachnoid web was made based on neurological exam and imaging findings.

Discussion: Spinal arachnoid web is a rare diagnosis, but consideration is important, as early recognition and surgical intervention can resolve symptoms and prevent worsening neurological sequelae.