Paragangliomas are neoplasms that arise from autonomic nervous system-associated paraganglia ; most often, they are benign, but have infrequently been reported to metastasize. Involvement of the spine is rare and is usually intradural at the level of the cauda equina. The authors report one case of metastatic malignant paraganglioma to the spine, which resulted in radiculopathy caused by extradural spinal root compression ; a review of the literature is also provided. Management of the reported patient involved spinal root decompression and spinal stabilization ; long-term symptom-free ambulatory status was maintained. After surgical removal of these tumors, radiation therapy may be an important adjunctive procedure.