Intramedullary abscess is a rare neurological condition . Normal spinal cord tissue has an exceptional ability to resist infection. Usually, intramedullary abscesses occur when the patient has a specific underlying condition. After an extensive literature search and review, we can summarize these conditions in four different categories: bacterial and fungal infection, penetrating trauma to the spinal cord, congenital dural sinuses, or chronic tuberculosis. Even more rarely, intramedullary abscess formation has been associated with acute bacterial meningitis.