Eosinophilic granuloma as a manifestation of localized or generalized histiocytosis X involved the vertebral column in a group of ten children. Characteristic radiographic findings include a variable degree of collapse of the vertebral body, either symmetrical or asymmetrical, lack of involvement of the intervertebral disc in all but one unusual case, and absence of any adjacent paravertebral soft tissue mass. Restoration of vertebral height occurred in varying degree. Seven lesions appeared to have made a compensatory spurt in height over a given period of time as compared with adjacent uninvolved vertebrae. The degree of restoration of vertebral height does not appear to be affected by the type of treatment given.