A case of vertebral sarcoidosis is presented with a review of the literature. Generally, patients are black and in the third or fourth decade of life. They are symptomatic, with back pain of varying intensity. Lytic lesions of vertebral bodies with associated sclerosis are usually found. There is a predilection for involvement of the thoracic vertebrae. More commonly, there is little or no disc-space involvement. Most patients are tuberculin-negative. In patients who meet these criteria, diagnosis of vertebral sarcoidosis should be considered.