Angiolipomas are benign tumours which usually arise from subcutaneous tissue, particularly in the forearm, but they do occur rarely in the spinal canal. To the best of our knowledge 60 cases of histologically confirmed spinal angiolipoma have been reported in the medical literature. They show a female predominance (1.6:1), and the mean age at presentation is 43 years. They usually arise in the thoracic spine, most cases presenting with slowly progressive signs and symptoms of cord compression. Rarely, massive acute haemorrhage into the tumour may herald its presence. Surgical resection or decompression are the most satisfactory methods of treatment in most patients. We describe three further cases of spinal angiolipoma, and discuss their aetiology, pathogenesis, clinico-pathological features and surgical management.