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The purpose of this study is to report a case of severe back pain following lumbar puncture (LP), which was associated with an accidental tether cord syndrome (TCS) in MRI. The patient was a 10-year-old boy that was hospitalized in the pediatric ward for severe headache and to rule out meningitis. First, LP was performed for him, but he suffered very severe back pain after LP. Lumbosacral MRI was performed to rule out collection or abscess formation, but the evidence of the TCS was accidentally found; however, it was too unexpected before. In the short term follow up, the symptoms of the patient were completely resolved by using analgesics. It was shown that his pain was as a result of LP. In general, although sometimes severe lower back pain after LP may be overwhelming, if neurologic examination were normal, it is important to assure parents that it would be resolved.