Neurosarcoidosis is a rare diagnosis, and it is also unusual for a patient with sarcoidosis to present solely with neurologic disease. However, CNS involvement can be the first manifestation of disease in 50% of patients. Thus, it is an important diagnostic consideration in patients presenting with ambiguous nervous-system lesions, particularly in the population most often affected by sarcoidosis: young African-Americans. We report a case of a 32-year-old African-American male with spinal sarcoidosis presenting as bilateral upper-extremity and upper-trunk parasthesias secondary to an intramedullary spinal lesion.