Abstract Spinal subarachnoid hemorrhage is a rare condition that usually occurs because of secondary causes and idiopatic spontaneous ones are seen extremely rare. We report a 56 years old woman who presented with severe head and neck pain and urinary retention. Magnetic resonance imaging revealed subarachnoid hemorrhage that extended from T1 to lumbar vertebrae. She was treated conservatively and symptoms were resolved within 1 month. Asymptomatic arachnoid cyst was observed on the follow up magnetic resonance imaging after 3 months with no neurologic detoriation. She was still stable clinically and radiologically at the end of 19 months. Spinal subarachnoid hemorrhage is a surgical emergency, although in some cases conservative approach may be useful.