Intraosseous neurogenic tumors are rare and have been reported most commonly in the mandible, possibly because of the long course of the mental nerve within this bone. They have also been reported very rarely in a vertebra. We experienced a case of intraosseous neurilemmoma arising from the body of the first lumbar vertebra, which resulted in paraplegia. The tumor was removed completely through anterior and posterior approaches by staged operation. Postoperative course was uneventful and paraplegia was recovered within three months postoperatively.