Cauda equina syndrome after epidural block is a rare complication, but it requires emergency surgery when it is diagnosed. A 65-year-old man who underwent epidural block at a local clinic was admitted with right lower leg weakness and decreased leg sensation, severe lower radiating pain, dysuria and decreasing sensation in the perianal region. Magnetic resonance image showed protruded disc material between L4-L5 and a hematoma that occupied most of the spinal canal and this was compressing the spinal cord. These findings were diagnostic for cauda equina syndrome after epidural block and so laminectomy, excision of the herniated disc and removal of the hematoma were done. At 6 months follow-up, the neurologic symptoms were resolved except for the dorsiflextion of the ankle and the big toe. We report here on a case of cauda equina syndrome as a rare complication after epidural anesthesia.