Melioidosis is an uncommon infection caused by a Gram-negative bacillus, Pseudomonas pseudomallei. Only a few case reports of orthopaedic infection have been published in English, and most were of isolated septic arthritis or secondary to melioidosis of another organ. We have reviewed ten patients with localised melioidotic osteomyelitis; six had underlying conditions. We discuss the importance of obtaining a bacteriological diagnosis, and of surgical debridement as well as appropriate antibiotic therapy.