Adequate exposure to sunlight and fortification of dairy products with vitamin D have eliminated vitamin D deficiency secondary to inadequate endogenous production or nutrition in the majority of countries. Insufficient vitamin D intake secondary to using unfortified foods and social customs (such as avoiding sun exposure), however, contribute to the development of disease. Poor diet, a lack of sun exposure, and the age related decline in the dermal synthesis of 7-dehydrocholesterol are among the factors that predispose to vitamin D deficiency and consequent bone disease. Here, we present a case of severe osteomalacia presenting with multiple vertebral fractures due to poor diet and a lack of exposure to sunlight.