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INTRODUCTION Spinal arteriovenous malformations (SAVMs) are very rare and can be very challenging to treat since none of the therapeutic options does provide a definitive cure to these lesions. We believe that incorporation of intraoperative angiography during surgery in a hybrid theatre can help achieve a better cure. CASE PRESENTATION We present a 45 years old woman with three (3) years history of weakness and ten (10) days' history of acute pain in right upper extremity. Magnetic resonance angiography (MRA) of the cervical segment of spinal cord revealed tortuous vascular masses from foramen magnum to the inferior margin of fourth cervical (C4) vertebral. Spinal digital subtracting angiography (DSA) confirmed vascular malformation at the cervical segment of the spinal cord with their origin from bilateral posterior spinal arteries. She was successfully operated on with the aid of intraoperative angiography without any neurological deficient. CONCLUSION Spinal angiography is the gold standard for all-inclusive assessment of SAVMs. Surgery and endovascular techniques equally have key therapeutic valves in treatment of SAVMs but a combination of the two gives a more accurate and reliable cure to this disorder.