Diffusion weighted imaging (DWI) may represent a valuable tool in the early diagnosis of spinal cord diseases. The purpose of this paper was to test the feasibility of a single shot fast spin echo (SSFSE) DWI in normal and abnormal spinal cord, and to evaluate its use in routine clinical imaging. We used a SSFSE sensitive to diffusion (b = 600 s/mm2) with multi-slice or single slice technique to study normal (32 cases) or abnormal (39 cases) spinal cords. Apparent diffusion coefficient (ADC) maps were calculated. Single slice sequences were significantly more reliable than multi-slice sequences for measurement of ADC. In normal subjects, mean ADC values were remarkably similar at both cervical and thoracic levels. Increased ADC values were detected in patients with cord trauma, myelitis, dural malformation, glioma, syringomyelia or metastasis, whereas decreased ADC values were detected in a patient with cervical intraspinal metastasis. This is the first report of the feasibility of a single slice SSFSE diffusion sequence for routine spinal cord imaging. The measurement of ADC may be of diagnostic value for the insight it offers on the pathophysiology of parenchymal damage.