B-cell lymphoblastic lymphoma (B-LBL) is an aggressive type of non-Hodgkin lymphoma that usually involves lymph nodes, skin and soft tissue. Bone marrow and peripheral blood are normally spared from involvement by the disease. B-LBL typically forms sold masses that have similar pathologic and immunophenotypic features of the liquid counterpart, B-cell acute lymphoblastic leukemia (B-ALL). Presentation of B-LBL with a solitary epidural mass at the cervical spine is very rare and the optimal treatment of such cases is unknown. Most of the literature on management of B-LBL comes from small case series, pediatric patients, or as part of retrospective data that combine B-LBL with B-ALL cases. The case presented herein, showed a unique presentation that was then treated with three modalities, namely, surgical resection, radiotherapy, and consolidation with systemic chemotherapy adopted from United Kingdom acute lymphoblastic leukemia (UKALL) protocol. The patient attained a complete response following the planned treatment and is still in remission five years from the time of his initial diagnosis.