A 24-year-old patient at 37 weeks’ gestation presented with a 2-day history of back pain; she developed paraplegia of both lower limbs and urinary incontinence 1 day later. The patient was in good health and had no history of underlying diseases including coagulopathy. Physical examination after admission showed absence of lower extremity reflexes, no proprioception, and complete sensory loss bilaterally to the T6 level. The Medical Research Council (MRC) scale evaluation indicated a lower limb strength score of 0/5. We performed an urgent thoracic magnetic resonance imaging (MRI) that showed SSEH at the T5–T6 level (). On T1-weighted images, the lesion was hyperintense and heterogeneous, while on T2-weighted images, the signals were hypointense and heterogeneous in the spinal cord. As the patient was 37 weeks pregnant, the obstetrician suggested the performance of a cesarean section before spinal canal decompression. Six hours after the cesarean section, the patient began to recover muscle strength in the lower limbs, and the MRC scale evaluation indicated a lower limb strength score of 2/5. Due to the rapid recovery of muscle strength, we chose not to perform spinal decompression. The patient underwent spinal artery computed tomography angiography (CTA) for examination of blood vessels of the spinal cord, and we were informed that the patient had PE. An emergency CTPA was performed, and left pulmonary artery trunk and small pulmonary artery emboli in each lobe of both lungs were identified (). D-dimer levels had increased to 3,567 μg/L. Color ultrasonography of the lower extremity showed no abnormalities. We also conducted autoimmune laboratory tests and reviewed the relevant coagulation routine test results, which showed no significant abnormalities. Unusually, the patient exhibited no symptoms of pulmonary embolism, such as dyspnea. Blood gas analysis revealed a partial oxygen pressure of 96 mmHg. Further test results, including blood oxygen saturation, were also normal. We administrated intravenous methylprednisolone (dose, 10 mg/kg/day for the 5 days) with no adverse reactions. On day 9 after admission, the MRI showed that the hematoma had been absorbed (). The patient’s lower limb muscle strength recovered to 4/5. The follow-up at 2 years showed that neurological function had completely recovered. A CTA of the pulmonary artery was also normal. A summary of the timeline is presented in.