Acute osteomyelitis of the vertebrae constitutes a clinical entity of interest and importance to both the internist and the surgeon. The disease consists of an acute suppurative spondylitis generally consequent on metastatic infection of the vertebrae at the time of a previous bacteremia, occasionally the result of the involvement of the vertebrae by a local inflammation that has spread by direct extension. The malady is serious, is often not recognized promptly and is attended with a considerable mortality. The American literature has paid this subject scant attention. The following sixteen cases, proved by operation or necropsy, have occurred in the Mount Sinai Hospital chiefly during the past seven years and are presented to serve as a basis for the analysis of the disease and its clinical aspects. The aim of this study is clinical. For statistical and theoretical discussions of the subject, the reader is referred to Volkman,1 Wilensky