Objective– To report a case of idiopathic spinal epidural lipomatosis (SEDL) presented with unique radicular pain most likely caused by enlarged veins surrounding nerve roots. Patient– A 26-year-old male presented with radicular pain of the right T6–T7 area. He also showed Becker's nevus in the corresponding area. CT myelography and magnetic resonance imaging revealed epidural lipomatosis posterior to T4–T8 of the spinal cord. Surgical removal of adipose tissue and a hemilaminectomy of T4–T7 were performed and resulted in relief of the radicular pain. Conclusions– Lipomatosis was histologically confirmed and surrounded by enlarged veins. These abnormally enlarged veins compressed the nerve roots and were thought to cause radicular pain. Also, Becker's nevus of this case seems to have some relationship with SEDL.