Pyogenic osteomyelitis of the cervical spine was successfully treated without bone grafting in 11 of 12 patients. Staphylococcus aureus was the most common organism. Four of the patients were heroin addicts, and six others had received parenteral injections under medical supervision. The patients were immobilized promptly, and after diagnostic procedures, cultures, and drainage when appropriate, they were treated with antibiotics, which led to spontaneous fusion in the 11 who survived. In the preantibiotic era, these infections frequently evolved into "epidural abscess", with resultant cord compression leading to permanent paralysis or death. Therefore, early differential diagnosis from tuberculosis or cancer is necessary. Today, with early diagnosis, immobilization, an anterior surgical approach when necessary, and the appropirate antibiotic, cure without neurological deficit should be the rule.