We present a case of an unusually large spinal epidural hematoma in an infant after a total breech extraction, which was diagnosed by high-resolution ultrasonography. The lesion appeared unusually large, homogeneous, and isoechoic to the spinal cord. This case demonstrates the ability of ultrasound to diagnose the nature of the lesion, its exact location and full extent. Magnetic resonance imaging was used in this case only as a secondary modality to demonstrate the hemorrhagic nature of the lesion.