Intervertebral discs are pads of fibrocartilage having the capacity to maintain stability under a wide variety of loading conditions, while permitting intersegmental motion of the spine and showing degenerative and aging changes earlier than any other connective tissue in the body. Disc degeneration may manifest as disc space narrowing, disc bulging, protrusion, extrusion, sequestration, annular tears, reduced signal intensity on magnetic resonance imaging, Schmorl's nodes and vertebral rim osteophytes. It is believed to be clinically important since disc degeneration has been found to be associated with back pain. This Perspective describes how disc degeneration can be distinguished from normal disc aging and reviews factors associated with intervertebral disc degeneration, with a focus on genetic factors in particular. IBMS BoneKEy. 2010 November;7(11):388-405.