Background Diffuse Idiopathic Skeletal Hyperostosis (DISH) or Forestier disease is defi ned as a non-infl ammatory ossifi cation of ligaments of the spinal colon [1]. It is mostly seen in the upper thoracic vertebra but can also occur anywhere on the vertebral colon [2]. Estimated prevalence is suggested between 2.9%-28% in general [3]. Mostly identifi ed as an incidental fi nding on plain radiographs or computerized tomography most cases are asymptomatic. But based on location and size symptoms may vary from neck and back pain, to dysphagia and eating disabilities. The incidence rises with age and several metabolic disorders like diabetes mellitus and hypercholesterolemia are risk factors for DISH [2,4]. We present a rare case of Forestier disease with multi-level vertebra involvement from the upper cervical to the thoracic area which has not been reported in the literature before.