Actualistic interpretation (on the basis of disorders documented in life) of pathology in modern turtles, and across the phylogenetic spectrum, allows confident diagnosis of disease in fossil turtles. Fortunately, those diseases that affect bone do so in a manner that appears independent of phylogeny and even of geologic chronology. To date, most pathologies have been reported as isolated observations. Therefore the latter have been characterized and placed within the framework of recognized diseases and activities. Toward this end, we surveyed the literature, assessing reports in terms of contemporary definitions. Epidemiologic studies of pathology in turtles are rare, with the exception of frequency of anomalies and of avascular necrosis and recognition of diving behavior. Notation of avascular necrosis in 50% of Cretaceous turtles, limitation to marine turtles, and its gradual reduction over geologic time present a unique window into turtle behavior and their development of strategies that minimize its occurrence.