Neurilemmoma is a benign neoplasm arising from the Schwann cell of the nerve sheath. Acoustic nerve is the most common site of neurilemmoma and mandible is the most frequently involved in intraosseous neurilemmoma. Extradurally located dumbbell type neurilemmoma was rarely reported. The histology of neurilemmoma was first described by Verocay in 1908 and elaborated upon by Stout in 1935. Characteristic histologic patterns of neurilemmoma were encapsulation and Verocay bodies, Antoni type A and B areas, palisading nuclei, and lack of malignant characteristics. We experienced such a rare case of neurilemmoma which probably arised from the left first lumbar spinal nerve root, and located extradurally and paravertebrally, and confirmed by radiologic and pathologic findings.