This movie briefs cervical cord intramedullary tumor (ependymoma) surgery in a young man with left hemiparesis. This movie especially overlooks the dissection of spinal fiber from such a huge tumor and its correlative feedback with neuromonitoring. One important thing that is the benchmark of this surgery is preserving anterior spinal circulation and how to be safe avoiding spinal cord ischemia. Lastly, this tumor didn't enhance brightly which is characteristic of ependymoma. We had a preop diagnosis of astrocytoma.