A 56-year-old man underwent cervical laminoplasty for cervical spondylosis. On the 7th postoperative day, he suddenly felt severe neck pain, and tetraplegia developed rapidly over 1.5 hrs. Computed tomography demonstrated a huge hematoma compressing the cervical spinal cord. Clot was evacuated 3 hrs after the onset of symptoms. The patient's postoperative course was uneventful. His blood pressure could not be properly controlled in the perioperative period. Surgeons should keep in mind that delayed postoperative spinal epidural hematoma (DPSEH) can occur more than a week after surgery, and meticulous blood pressure control is important for more than a week after a spinal operation.