Background: The intramedullary spinal cord tumors are relatively uncommon disease that can leave the patients neurologically and functionally devastated. Aim and Objectives: Identifying the operative strategies for completing resection of intramedullary spinal cord ependymomas as well as assessing the functional results of patients over the postoperative follow-up period. Patients and methods: This prospective and retrospective study was conducted on twenty-five consecutive patients, harboring intradural intramedullary spinal cord ependymomas, all were operated on at Al Azhar University hospitals starting from June 2012 till June 2021. Results: There was not a statistically significant distinction among the groups that were evaluated concerning the pathological subtypes of spinal ependymoma with the degree of surgical excision and outcome. There was a statistically significant relation between pre-operative clinical state and the clinical outcome postoperatively as if the patient had no or mild motor affection preoperatively, the clinical results were much better p-value 0.000. Conclusion: early diagnosis, and early treatment guarantee the best clinical outcome for those patients.