Abstract: Spinal pathology commonly features in physiotherapy caseloads and a detailed knowledge of the features of Cauda Equina Syndrome (CES) is essential. While CES is a rare presentation, if missed the consequences of permanent bladder, bowel and sexual dysfunction are devastating. CES has a varied presentation in terms of chronology and symptomatology, leading to difficulty in accurate diagnosis in a clinical setting. The case study of a 48 year old female who developed CES while attending physiotherapy is presented. Her subjective and physical examination findings together with her lumbar Magnetic Resonance Imaging (MRI) findings are outlined. The patient underwent an L5/S1 subtotal laminectomy and discectomy and the patient’s status at eight months post-operatively is presented. A comprehensive review of the aetiology, sub-classifications and clinical features of CES is also provided.