A case of Salmonella vertebral osteomyelitis with epidural abscess in a child with sickle cell anemia is presented. Spinal osteomyelitis is a rare event in children. Although osteomyelitis in sickle cell anemia may occur in any bone, it has most often been documented as beginning in the medullary cavity of the long and tubular bones. This is in contrast to the clinical presentation of osteomyelitis in the normal individual, who is likely to have infection beginning in and restricted to the metaphyseal regions of bones. Nonspecific or constitutional symptomatology may obscure the diagnosis of vertebral infection with ensuing cord compression. This case stresses the rapidity of development of paralysis or other neurologic complications, as well as the difficulty and emergent nature of the diagnosis of epidural abscess in this situation.