The efficacy of bone morphogenetic proteins (BMP) in infection has not yet been established. Since fusion is a necessary aim in the treatment of vertebral osteomyelitis with spinal instability, BMP may be a helpful adjunct in the surgical treatment of these cases. We present a case of vertebral osteomyelitis associated with neurologic deficits, treated with decompression and fusion using recombinant human bone morphogenetic protein-2 (rhBMP-2) and titanium cage device. Eradication of infection, recovery of neurologic deficits, spinal stabilization and solid fusion were achieved and maintained at 5 years follow-up.