Salmonella osteomyelitis is rarely seen and vertebral involvement by this organism is very rare, especially in childhood. Salmonella should be considered in the list of etiologic agents of osteomyelitis in sickle cell disease. Herein we report a five-year-old boy with sickle cell disease and Salmonella paratyphi B spondylitis who was diagnosed with atypical clinical findings of infection. We would like to emphasize the importance of differentiation between osteomyelitis and infarction even if there is no obvious sign of infection in the sickle cell patient even at atypical localization.