Spinal epidural abscess (SEA) can be challenging to diagnose and, if missed, may result in significant morbidity, mortality, and increased malpractice risk. This case-based course reviews approaches to improve SEA diagnosis by exploring risk factors and mimics and discusses strategies designed to improve patient safety and decrease malpractice risk. Expert audio commentaries from a practicing emergency department physician and a medical malpractice defense attorney provide insightful strategies that physicians and other clinicians can use to improve patient outcomes and the defensibility of the medical care provided.