Currently there is no consensus how to reduce the risk of hemorrhage in spinal decompression surgery of hypervascu- lar spinal tumors. A retrospective study of 128 patients oper- ated in our institute was held in the period between 2003 and 2014. There were 80 male and 48 female patients with extradural hypervascular spinal tumor. The study included 71 patients with metastases of renal cell carcinoma, 28 - with multiple myeloma, 18 - with plasmacytoma and 11 - with aggressive hemangioma. The first group included 59 patients who underwent preoperative tumor embolization. The second group consisted of 69 patients who were treated surgically using intraoperative local hemostatic agents. We performed 2 types of treatment options: palliative decompression and total spondylectomy. We did not get evidence that embolization was more effective than using local hemostatic agents for patients with hypervascular spinal tumors who underwent palliative decompression. In the same time efficiency of embolization for patients with total spondylectomy was significantly higher.