Background: Spine hemangioendothelioma is a rare low-grade vascular neoplasm that is characterized as intermediate between benign hemangioma and high-grade angiosarcoma, affecting 1 in 1,000,000 people worldwide. It has been described throughout the body with lung, liver, skin, bone and spine being the most frequent sites. Case presentation: A 31-year-old male, complained of mid and lower back pain for 2 years, which was on and off. 5 months ago pain increased after lifting heavy object, which affected his walking and sitting. No weight loss or night sweating. He came to Dr. Solaiman Fakeeh Hospital as second opinion regarding the Lumbar 1 (L1) tumor. The patient was diagnosed with pseudomyogenic hemangioendothelioma according to radiological images and histopathology report in other center. Conclusion: Through our experience in this case in the management of spine hemangioendothelioma tumor resection should be attempted whenever possible. Given the propensity of these lesions to recur, intralesional or subtotal resection