Abstract: Vertebral osteomyelitis (VO) is an infection that can lead to significant morbidity including paralysis and chronic pain. Identifying the responsible organism poses a challenge to the physician. Vertebral aspirates are often used to sample the infected region in an attempt to identify the responsible microbe when cultures of blood are negative or reveal an organism not typically associated with VO. To identify the clinical features of patients with coagulase-negative staphylococcal (CNS) VO, we reviewed 272 vertebral aspirates obtained at our institution over 5 years. We identified 7 patients with cultures that yielded CNS. All patients had indwelling intravascular lines or devices. All patients in whom blood cultures were performed had CNS isolated from cultures of blood. Four of the 7 patients had resolution of the infection with antibiotic treatment alone, and 2 patients required surgical intervention. Coagulase-negative Staphylococcus may be an etiologic pathogen when it is isolated from multiple cultures of blood in patients with VO and additional risk factors including an indwelling intravascular line or device.