This chapter explores provocative testing, also known as the Spinal Wada test, a vital tool to assess spinal cord ischemia risk prior to spinal arteriovenous malformation (SAVM) embolization. Originating from studies by Doppman et al., this reversible diagnostic method uses pharmacologic agents to temporarily disrupt neural pathways, offering a window into at-risk regions of the spinal cord. It guides clinicians in identifying ASA and PSA anastomoses critical for determining embolization risks. Detailed discussion covers spinal vascular anatomy, endovascular intervention principles, and procedural techniques, including the choice of drugs, anesthetic considerations, and neurophysiological monitoring. Emphasis is placed on interpreting neurophysiological changes, acknowledging potential pitfalls, and optimizing patient safety. By highlighting this test’s high negative predictive value and nuanced limitations, this chapter underscores the Spinal Wada test’s essential role in enhancing clinical outcomes during SAVM embolization and advancing patient safety in spinal interventions.