SAPHO syndrome is an entity that associates musculoskeletal disorders with dermatological alterations. The most characteristic clinical manifestation of the SAPHO syndrome is pain in the anterior chest wall, due to the involvement of the sternoclavicular and costochondral joints. The etiology of SAPHO syndrome is unclear. The treatment is not protocolized. Nonsteroidal anti-inflammatory drugs (NSAIDs), sulfasalazine, systemic corticosteroids, colchicine, methotrexate, and antibiotics such as tetracyclines have been used with varying results. The use of bisphosphonates has been described as effective. Biological therapy also seems to be effective. More trials with these drugs are needed to evaluate their effectiveness against this disease and to establish the number of doses, the amount, and the interval between them. In this chapter we describe the case of a patient with SAPHO syndrome who had a good response to oral alendronate.