Iliopsoas abscess is relatively uncommon condition that can present with vague clinical features. Its insidious onset and occult characteristics can cause delayed diagnosis, resulting in high mortality and morbidity. We report a 49-year-old male with T7 complete paraplegia (ASIA A) as a result of motor vehicle accident in 1994, presented with fever above 40degrees C and myalgia for 15 days and later diagnosed as iliopsoas abscess. Magnetic resonance imaging showed infectious spondylitis, L3, with abscess formation in psoas muscle, bilateral. Intravenous broad spectrum antibiotics treatment, CT-guided percutaneous drainage and surgical management were performed. Febrile episodes are frequent in SCI (spinal cord injured) patients. However, it is sometimes difficult to ascertain the origin of fever in SCI patients, because of altered sensation and lack of localizing physical findings. We suggest that this infectious pathology must keep in mind in SCI patients with fever of unknown origin.