Thirty-five cases of vertebral histiocytosis are examined for a total of 52 vertebrae affected. The study is conducted on the radiographic picture at the onset and at long-term follow-up in 32 cases (24-223 months, average 45). Diagnosis may be based on radiology only in typical cases, otherwise there may be errors in differential diagnosis with malignant neoplastic lesions. Radiotherapy does not seem to influence the volumetric reconstruction of the vertebral body, which is inversely proportional to age. In those cases submitted to chemotherapy, the morphological results, in the absence of other types of local treatment, are often excellent. Orthesic or surgical treatment must be chosen based on the extent of the lesion and on its ability to progress; CT scan may be useful to this purpose, but initial orientation may be suggested by multiple adjacent lesions or by radiographic images such as osteolysis of the pedicles.