Tethered cord syndrome is the low positioning of conus medullaris caused principally by maldevelopment of filum terminalis. In about 50% of cases filum terminalis is attached to a spinal lipoma. This paper presents a 5-year-old patient with a residual filum terminale lipoma after a spinal operation which is diagnosed utilizing fat-water MR imaging which is the only reliable method of examination to verify the presence of fat.