Patients with Hodgkin lymphoma (HL) usually present with lymphadenopathies. Osseous involvement at presentation is extremely rare. Occurrence of both eosinophilia and osseous involvement has not been reported frequently. We present an adolescent female complaining of lower back pain for 6 months, in whom, multifocal vertebral involvement and peripheral blood eosinophilia preceded the final diagnosis of HL. Pediatr Blood Cancer 2010;55:560-561 (C) 2010 Wiley-Liss, Inc.