Introduction Solitary plasmacytoma of the vertebra is a rare condition. Treatment options include radiotherapy, surgery, radiotherapy combined with surgery, and vertebroplasty or kyphoplasty. Although radiotherapy is the treatment of choice for solitary plasmacytoma of the spine, recommendations for treatment have been based on limited data from retrospective studies. Material and Methods Thirteen patients of solitary spinal plasmacytoma were treated at Sohag University Hospital between 2003 and 2014. Patients were 12 males and 1 female. Age ranged between 35 and 74 (mean 57.7) years. Lumbar spine was affected in 7 patients and thoracic spine in 6 patients. Pain was assessed on Denis pain scale. On presentation 8 patients had pain grade P5, 4 patients had pain grade P4 and 1 patient had pain grade P2. The Frankel grading system was used to assess the neurologic outcome. On presentation, 6 patients had neurological deficits; 3 Frankel grade C, and 3 Frankel grade D. Indications for surgery included pathological fracture (9 patients) and neurological compromise (6 patients). All patients received operation through a single posterior exposure. The lesion was curetted and anterior reconstruction was achieved by spinal shortening (5 patients), or anterior bone grafting (6 patients), and anterior reconstruction was not needed in 2 patients. Then posterior fusion was performed. Radiotherapy began 3 weeks after the operation. Results All patients got neurological recovery to Frankel grade E and improvement of pre-operative pain (6 patients to P1, 5 patients to P2 and 2 patients to P3). No local recurrence occurred after follow up for 7–102 (mean 36.9). Conclusion Gross-total tumor resection on piecemeal basis with post-operative adjuvant radiotherapy for solitary plasmacytoma of the spine gives long-term local control of the tumor. It can help to improve patient's quality of life.