Dumbbell neurogenic tumor is a rare disease, arising about 10 % of mediastinal neurogenic tumor. We report a 31 year old man who was suffered from paresthesia and weakness of lower extremities for about 8 months. Chest x-rays revealed a dumbbell shaped mass shadow in left lower posterior mediastinum. MRI demonstrated a well defined dumbbell shaped mass in the mediastinum of T7 level, including spinal cord compression by the extended tumor into the spinal canal and enlarged intervertebral foramen. The patient underwent one-stage combined resection of the tumor through the thoracotomy and laminectomy, simultaneously. The tumor was confirmed as neurilemmoma. The postoperative course was smooth and uneventful.