Transverse myelitis (TM) has rarely been reported in association with tetanus toxoid-containing vaccines. Here, we report a 46-year-old man presented with progressive paresthesias and weakness in his arms and legs following an intramuscular injection of adult-type diphtheria and tetanus toxoids (Td). This is the sixth reported case of TM following Td vaccination. Physicians must be aware of this rare but serious side effect when prescribing Td vaccine and postvaccinial TM must be kept in mind when making a differential diagnosis of TM.