Pyramidal Syndrome (PS) produces unilateral pain on sciatic notch, irradiated to the sciatic nerve and elicited by Lasegue’s/FAIR signs. Pyramidal muscle (PM) is a rotator and adductor of the hip. There is 6.15% anatomical variance on sciatic nerve when crossing the PM. The entrapment of sciatic nerve by this muscle reproduces PS symptoms. There is controversy of PS as a disease entity, based on clinical, radiological ad neurophysiological assumptions. The objective of this paper is to present a 41 year old female with signs and symptoms of PS, and to characterize this syndrome based on clinical, radiological and electrophysiological exams. By doing this, we could suggest that in this case, PS is a disease entity with typical features.