We report a patient with thoracic spinal cord granuloma whose initial symptoms were lumbago and inguinal pain. A 62-year-old woman had persistent lumbago and right inguinal pain. Thereafter, the patient developed sensory impairment of the right lower limb. Since the pain did not improve with medications, she was referred to us. The patient denied having intermittent claudication. Physical examination revealed bilateral exaggerated Achilles tendon reflexes. The motor impairment was progressive. MRI of the thoracic spinal cord disclosed intramedullary nodular lesion at the 10^th thoracic vertebral level that was enhanced by gadolinium. Pathology of the removed lesion was granuloma. Spinal cord lesions should be borne in mind when patients have pain and progressive neurologic impairment. Imaging studies such as MRI should be done to clarify the etiology.