Four cases of Aspergillus osteomyelitis are presented and the world literature is reviewed, for a total of 19 cases. Aspergillus osteomyelitis is largely a disease of immunosuppressed hosts, although wound and other infections in "normal" hosts are seen. In children, contiguous spread from an adjacent pulmonary infection is most common, whereas in adults hematogenous spread is the rule. The survival rate in immunocompromised patients is poor, whereas the cure rate is uniform in "normal" hosts. A combined medical-surgical therapeutic approach has been used most often and seems appropriate.