Spinal dural arteriovenous fistulae are the most common type of spinal vascular malformations (AVMs). They have been classified into four types: dural AVM (type I), glomus AVM (type II), juvenile AVM (type III), and intradural direct arteriovenous fistula (type IV). Intradural AVMs manifest as subarachnoid or intramedullary hemorrhages, whereas dural AVM manifest as epidural hematoma. Spinal osseous epidural arteriovenous fistula (AVF) is not a well-defined vascular abnormality in the spine and consists in a high-flow vascular lesion outside the dura or spinal canal. It is located in the extradural space involving a bone at the area of the dilated venous sac to which all the feeders converge to the margin. We describe the case of a 14-year-old girl with cervical epidural hematoma caused by a spinal epidural arteriovenous fistula.