Central nervous system hemorrhage is an uncommon and potentially devastating event in hemophiliacs, with an incidence of 2-8%. Intraspinal hematomas account for 8.5% of CNS hemorrhages in patients with factor VIII or IX deficiencies. Although most reported cases in this population are secondary to trauma, there are a few reports of spontaneous hemorrhage. We present a case of spontaneous spinal epidural hematoma (SSEH) in a child with Hemophilia B, factor IX deficiency, and review the relevant management strategies.