To investigate the clinical characteristics, neurological manifestations, and survival outcomes of patients with pathologically confirmed spinal lymphoma and to identify factors associated with prognosis. We retrospectively reviewed consecutive patients with pathologically confirmed spinal lymphoma treated at the First Affiliated Hospital, Zhejiang University School of Medicine, between Jan 2012 and Dec 2025. Clinical characteristics, treatment patterns, and survival outcomes were analyzed. Overall survival (OS) was estimated using the Kaplan–Meier method, and prognostic factors were evaluated using Cox proportional hazards models. Sixty-three patients were included. The median age was 63 years, and 90.5