Spinal cord compression is a common neurological emergency. The causes of spinal cord compression may include primary or (more frequently) metastatic tumor, infections, trauma, and vertebral or intervertebral disc disease. In most instances the underlying etiology is known or easily ascertained. We present here three recent cases in which patients presented with spinal cord compression and lytic bone lesions suggesting metastatic cancer. In these cases, vertebral osteomyelitis was found to be the cause.