Objective: To characterize possible risk factors for Vascular Myelopathies (VM) in order to potentially increase their recognition and distinction from inflammatory myelopathies. Background: Although the diagnosis of “Transverse Myelitis” (TM) is widely used in the clinical setting, the recognition of VM, which can mimic cases of TM, is critical for establishing the proper treatment. Risk factors for VM have been suggested from case studies but are not well established in large groups of patients. Methods: Eighty patients with clinical and radiological (MRI and/or angiography) profiles consistent with VM were identified among patients previously referred to a specialized center for evaluation of TM during the period between 2010 and 2014. Forty-two possible risk factors, which included past medical and family history at the time of presentation, were assessed by retrospective review of the clinical records. Another group of 80 patients with diagnosis of inflammatory myelopathies were used as disease-control group. Risk factors were evaluated using single variable and multivariate statistical analysis. Results: Risk factors associated with VM included male sex (p 0.0379), history of arterial hypertension (p 0.0336), dyslipidemia (p 0.0182) and smoking (p 0.0361). A recent history of extraneous exercise, especially weight lifting, was also associated with VM (p 0.0136). A weighted score of combined risk factors for vascular disease that were not significant in the initial analysis (i.e., history of cancer, severe hypotension, Valsalva maneuvers, coronary artery disease and diabetes) showed a strong statistically significant distinction between VM and TM. Conclusions: A thorough clinical history with emphasis on past medical, personal and family history, and activities prior to the onset of the symptoms is critical to identify potential risk factors for VM in patients who present with a myelopathic syndrome. Study Supported by: The Bart McLean Fund for Neuroimmunology Research and Johns Hopkins Project Restore. Disclosure: Dr. Barreras has nothing to disclose. Dr. Quiroga has nothing to disclose. Dr. Gailloud has received personal compensation for activities with Codman Neurovascular as a consultant. Dr. Gailloud holds stock and or stock options in Artventive Medical as a co-founder. Dr. Gailloud has received research support from Siemens Medical Dr. Pardo-Villamizar has nothing to disclose.