An 80 years old man arrived at the Emergency Department after an accidental fall from a 2-meter-height. In two hours he developed motor impairment of the upper extremities and urinary retention. An angio-MR showed an altered signal area of post-traumatic origin in the intersomatic space between C3 and C4. Clinical and instrumental data led us to the diagnosis of traumatic central spinal cord syndrome (CCS). CCS is the most common incomplete spinal cord injury (SCI) syndrome, accounting for approximately 9% of traumatic SCIs; it is characterized by disproportionate impairment (weakness and reduced function) of the upper limbs compared with the lower limbs, bladder dysfunction and varying degrees of sensory loss at and below the level of lesion. It has a favorable prognosis among the SCIs.