Identification of postcranial reptile pathology unrelated to trauma on the basis of macroscopic (visual) examination is feasible and effective, as previously documented in mammals, birds, and dinosaurs. Such bone disease is rare in most wild-caught lizards, with the exception of Varanids, and is also more common in crocodilians. This provides a basis for evaluation of the fossil record, suggesting that the most productive epidemiologic analyses would be concentrated in the families, Crocodylidae and Varanidae. A specific form of inflammatory arthritis and vertebral pathology, spondyloarthropathy, is clearly established as the major non-traumatic osseous pathology in lizards (although quite rare in all but varanids) and crocodilians. Calcium pyrophosphate deposition disease seems to represent a secondary phenomenon, apparently limited in distribution to individuals with spondyloarthropathy. Only 9% of individual reptiles with osseous pathology examined lacked a clear diagnosis substantiated by validated observations in human and other animals.