This chapter provides detail description of Clinical features and diagnosis of tumors of spine and spinal cord. Classification of neoplasms causing cord compression, tumors of the spinal cord, tumors of the vertebral column, intraspinal extension of paravertebral tumors, pathophysiology of cord compression, symptoms and signs of spinal compression, sensory disturbances, motor disturbance, sphincter disturbances, disturbances of autonomic functions, clinical features of tumors at different levels of spinal cord, epiconus syndrome, conus syndrome, cauda equine syndrome, differentiation of extramedullary and intramedullary tumors, alignment of cord segments and vertebrae are described in detail. One table is included to highlight clinical differences between extramedullary and intramedullary tumours. 54 references are included at the end of the chapter to facilitate further reading