Spinal sarcoidosis is a rare manifestation of sarcoidosis that can present a major diagnostic challenge. Herein we present a case of a previously healthy 55-year-old man who presented with leg weakness and was found to have diffuse involvement of his spinal cord by neurosarcoidosis. He was treated with steroids and recovered completely. The clinical characteristics, radiographic and laboratory findings of spinal sarcoidosis are discussed. Management strategies, including the use of newer targeted therapies, are also reviewed.