Actinomycosis with spinal involvement is very rare. We report a case of spinal actinomycosis with symptoms of spnal cord compression. A 55-year-old women had quadriparesis without evidence of systemic infection. In MRI findings, perivertebral granulomaous mass was compressing the sipinal cord at the level of first thoracic sipine with the signal change of cord and bony destruction. The patient was treated with two-staged opreations, antibiotics and rehabilitation training. She has improved neurologically and also in general condition. Due to rarity of incidence of entity, we reviewed the pertinent literature with discussion of diagnosis, treatment and the prognosis of this disease.