Emphysematous osteomyelitis is a rare entity that characteristically presents with intraosseous gas and positive bone cultures with gas-forming bacteria. We present a case of a 63-year-old woman who presented with lower back pain, decreased appetite, and unintentional weight loss over three weeks. Thoracic spine Computerized tomography image showed an ill-defined lytic lesion containing gas in the T12 vertebral body with anaerobic bone cultures, which grew