Although osseous involve-ment by sarcoidosis is well recognized,vertebral involvement is apparently rare. It was occasionally been reported in autopsy material, but its presence has not previously been documented in a living patient. This is a report of a 33-year-old colored male with known sarcoidosis whose presenting clinical features were fever, back pain, and paralytic ileus. Roentgenograms showed a lytic vertebral lesion thought to be tuberculous. Biopsy obtained at operation for spinal fusion revealed non-caseating granulomata suggestive of sarcoidosis, tubercle bacilli could not be isolated on culture, and there was subsequent healing without anti-tuberculous therapy. It is suggested that more extensive roentgenographic bone surveys be done in patients suspected of having sarcoidosis and that sarcoidosis be considered in the differential diagnosis of obscure destructive disease of the vertebrae.