Background: Hemangiomas of bone are localized benign tumors composed of fully developed adult blood vessels. Vertebral hemangiomas are present without symptoms in approximately 10% of the population and more common in females. It is usually located in the lower thoracic and lumbar vertebra and are often multifocal. Infrequently these benign lesions may cause local or radicular pain and neurological deficits ranging from myeloradiculopathy to paralysis. The physiological vascular, hemodynamic and hormonal changes in pregnancy act to enlarge a preexisting hemangioma and most of these changes peak in the third trimester. The most important contributing factor is the increase in venous pressure resulting from mechanical obstruction of blood flow from the paravertebral veins into the inferior vena cava by the gravid uterus. Objective: To study the outcome of management of a case of spinal hemangioma during pregnancy. Case report: A 26-years-old pregnant female patient attended the Department of Orthopedic Surgery at the International Medical Center Hospital, Jeddah, Saudi Arabia, suffering from a severe lower limb paresis and loss of sphincteric control and diagnosed with spinal hemangioma. An intervention was done during pregnancy to prevent further complications by decompressing the spinal cord. Post-delivery, the main surgery was performed to prevent the recurrence. Conclusion: The management of spinal hemangiomas in pregnant women can be done in the following two steps. The First step is short-timed, less bloody intervention to decompress the mass to prevent further damage and complications. The second step is to perform the main surgery post-delivery when the condition permits.