Spinal ependymomas(SEs) are common adult intramedullary tumors; however,determining the absolute boundary between the tumor and the tumor residual may be difficult. We assessed outcomes following the use of fluorescein sodium(FS) during surgical removal of SEs. We performed a retrospective analysis of 112 patients with SEs who were treated at Beijing Tsinghua Changgung Hospital between December 2014 and December 2016. Each patient received intravenous FS(3–4 mg/kg) to determine the SE boundaries during surgery. Tumor removal efficiencies and tumor residuals were assessed using magnetic resonance imaging(MRI) at 10 days and 3 months after surgical recovery; McC ormick’s spinal function classification was also performed at the 3-month follow-up. The complete tumor removal rate was 92%(103/112). Ninetyfour patients underwent tumor removal under fluorescent light, which provided distinctive tumor fluorescence. Tumor removal under white light was performed in18 patients; fluorescent images were invisible or indistinctive in these 18 patients. At the 3-month follow-up, sensory function(85.8%(91/106)) and movement(84.3%(86/102)) were improved in patients with pre-surgical dysfunction; urination and defecation functions were improved in 66.7%(16/24). The Mc Cormick spinal cord functional classifications, at the 3-month follow-up, showed significant differences in the percentages of patients with disease classified to each grade(I–IV), compared with preoperative classifications(each, P < 0.05). There was no MRI evidence of tumor relapse or residuals at the 3-month follow-up. FS use during the surgical treatment of SE enables complete tumor removal and detection of tumor residuals.