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Dural arteriovenous fistulas (DAVFs) of the spine are a rare but treatable cause of progressive myelopathy, typically affecting the thoracic spine and presenting with insidious lower limb neurological symptoms. While they most commonly occur in the 5th to 6th decade of life, atypical presentations necessitate a high index of suspicion, particularly in cases of longitudinally extensive myelopathy. Misdiagnosis as transverse myelitis can lead to inappropriate corticosteroid treatment and lumbar puncture, potentially worsening symptoms.We describe three cases of DAVFs initially diagnosed as transverse myelitis, highlighting the diagnostic challenge.A 38-year-old male presented with subacute lower limb sensory loss, weakness, and faecal incontinence. MRI revealed T2 hyperintensity from the cervicomedullary junction to C5, initially attributed to transverse myelitis. Angiography later confirmed a left meningohypophyseal trunk DAVF, which was successfully embolised. A 50-year-old male developed acute lower back pain and progressive sensorimotor deficits. Diagnosed with transverse myelitis, he deteriorated following lumbar puncture and corticosteroid therapy. Further imaging revealed a spinal DAVF at T11. A 68-year-old male presented with acute quadriparesis and MRI findings extending from the medulla to the thoracic cord. He deteriorated rapidly post-lumbar puncture and was referred to our centre, where angiography confirmed a complex cervicomedullary junction DAVF requiring surgical disconnection.These cases emphasise the importance of recognising DAVFs in acute myelopathy, particularly when lumbar puncture and steroid treatment exacerbate symptoms. Early vascular imaging and multidisciplinary input from neurology, neurosurgery, and interventional radiology are essential for timely diagnosis and management to prevent irreversible neurological deterioration.