Although posterior reversible encephalopathy syndrome (PRES) is a widely encountered clinicoradiological entity, spinal cord involvement on MRI is very rarely reported. We found only eight cases that have been reported so far. Reports of post-contrast meningeal or parenchymal enhancement in PRES are even rarer. Herein we report a case of PRES with extensive spinal cord signal abnormality with contrast enhancement. Familiarity with this rare imaging finding of PRES, in the appropriate clinical setting, will avoid unnecessary investigations and inappropriate treatment.