Purpose : Fibrocartilaginous embolism (FCE) causing spinal cord ischemia is poorly understood. Although rare, its clinical impact is significant due to rapid progression of motor paralysis despite minor trauma. Here we report a case of FCE. Case Presentation : A 23-year-old man without a significant prior medical history experienced lower-limb numbness and lumbar pain 15min after falling on his buttocks, with paraplegia and bladder and rectal dysfunction developing 1 h later. Proprioception was retained. Intramedullary high-intensity signals within the spinal cord from T8 to the conus medullaris were detected on T2-weighted magnetic resonance imaging (MRI). Suspecting spinal cord ischemia in the anterior spinal artery area, we initiated treatment with steroids, edaravone, aspirin, and hyperbaric oxygen therapy, considering the possibility of myelitis and demyelinating diseases. Subsequently, aortic dissection and other vascular abnormalities were ruled out by contrast computed tomography, and coagulation abnormalities, vasculitis, immune and demyelinating diseases were ruled out by blood tests and cerebrospinal fluid analysis. Intramedullary high-intensity signals on diffusion-weighted imaging and low signal changes on apparent diffusion coefficient MRI were observed. On contrast-enhanced MRI, no contrast-enhanced lesions were observed. The patient was able to walk with a cane at 37 days post-injury, and the neurological deficits disappeared after 3 months. Discussion : Although veterinary medical literature has reported more cases in various animals, it is difficult to make a histological diagnosis of FCE in humans because it requires a spinal cord biopsy. Therefore, it is necessary to make a diagnosis primarily through the exclusion of conditions such as infection, myelitis, vasculitis, coagulation disorders, and demyelinating diseases based on the characteristic clinical course, neurological symptoms in the anterior spinal artery area, and abnormal findings consistent with vascular distribution mainly on axial MRI. The pathophysiological mechanism involves intervertebral disc components entering the spinal cord microcirculation due to increased intradiscal pressure, then retrogradely flowing into the radicular arteries, causing embolization in the anterior spinal artery area. Treatment methods are lacking, and prognostic reports are inconsistent. It is important to be aware of the possibility of FCE and accumulate further case studies in the future.