Abstract: To the Editor: A lumbar epidural block is used to treat patients with a herniated intervertebral disc, spinal stenosis, or lumbosacral radiculopathy. This approach reduces radicular pain by decreasing inflammation of nerve roots through epidural corticosteroid injection.[1] Patients with moderate?to?severe spinal stenosis who taking various anticoagulant agents have more risk for epidural hematoma. For patients on anticoagulation therapy, guidelines have been established to decrease the risk of bleeding and its potentially devastating complications. We report a case of an 81?year?old man with an unexpected lumbar epidural hematoma, who achieved a good outcome with conservative management.