Cartilaginous embolization of spinal vessels is a rare cause of spinal cord infarction. A 63-year-old woman developed sudden onset of painful, fatal paraparesis following a valsalva-like maneuver. Autopsy demonstrated recent nonhemorrhagic infarction of the caudal thoracic spinal cord secondary to complete occlusion of the anterior spinal artery by cartilage. The literature pertaining to 28 previously reported cases is briefly reviewed.