Pyogenic vertebral osteomyelitis is said to occur when the osseous vertebral column and its associated structures are infected by pyogenic bacterial organism. Since as far back as 7000 BC, there is evidence of the human spine being ravaged by infectious agents in prehistoric man. Vertebral infection was described by both Hippocrates (400 BC) and Galen (150 AD), but Lannelongue in 1880 described the first reported series of pyogenic spine infections. Kulowski, in 1936, demonstrated an extravertebral site of origin for vertebral osteomyelitis from septic lesions of the skin. Until relatively late in the 20th century, the diagnosis had a lethal outcome in young patients. Mortality rates of over 70% for people under the age of 30 were reported. After 1940, improved diagnosis and treatment options reduced the mortality rate to about 25%. With the advent of potent antibiotics and safe surgical techniques, the aura of PVO has considerably abated. Today, pyogenic vertebral osteomyelitis is a relatively uncommon condition and when diagnosed early and targeted treatment initiated promptly, has a favourable outcome.