Pyogenic vertebral osteomyelitis, which is not uncommon in adults, is rare in children. Furthermore, the clinical presentation is often subtle and nonspecific. As a result, vertebral osteomyelitis is often not considered in the initial evaluation in children, resulting in a delay in diagnosis and treatment. We report a 3-year-old boy who was eventually diagnosed with pyogenic vertebral osteomyelitis and treated successfully with antibiotics. The patient initially presented himself with mild fever and abdominal pain for one week. Urinary tract infection, initially considered due to dysuria with suprapubic tenderness, was ruled out. Further investgation revealed that he had right sided suprapubic tenderness and low abdominal pain. He refused to sit or walk, and preferred a recumbent position with his knees bent. The magnetic resonance imaging study showed findings of L2-L3 vertebral osteomyelitis. With 4 weeks of intravenous cephradine treatment, the patient improved clinically and radiologically.