A subset of patients exhibit a recurrent form of transverse myelitis (TM). The Johns Hopkins TM Center defines recurrence as the presence of more than one episode of TM meeting the criteria for TM with intervening improvement and excluding the presence of multiple sclerosis. Some of those patients may have autoimmune forms of myelitis and optic neuritis that fit the criteria for Neuromyelitis optica (NMO) or NMO spectrum disorders. Other patients with recurrent TM may have myelopathies associated with rheumatological disorders including Sjogren’s syndrome, SLE, or systemic disorders such as sarcoidosis. Patients with recurrent pattern of TM should be evaluated extensively with CSF and serological studies for exclusion of such disorders.