Primitive neuroectodermal tumors (PNETs) are malignant, poorly differentiated neoplasms derived from the neural crest.1 They include cerebellar medulloblastomas but can also arise in the cerebral cortex (supratentorial PNETs), pineal region (pineoblastomas), spinal cord, cauda equina, and peripheral nerves.2 Only a few cases of primary intraspinal PNETs have been reported in children3-14 and in adults.15-17 To our knowledge, there has only been one previously reported case of intramedullary PNET of the cervical spine in an adult.17 In this article, we present a rare adult patient with a primary intramedullary cervical PNET and describe his treatment regimen and outcome