Hematogenous pyogenic vertebral osteomyelitis (VO) is a rare and often fatal complication of osteomyelitis that can affect individuals with underlying medical conditions, hospital-acquired infections, and intravenous (IV) drug abuse. Pyogenic vertebral osteomyelitis can present with generalized back pain, pyrexia, motor weakness, and neurologic deficits. The enigmatic presentation of this condition often results in delays in diagnosis and an increase in mortality. This case report aims to bring awareness to complications of hematogenous pyogenic vertebral osteomyelitis as well as highlight the need for further studies in order to establish standardized treatment. In our report, we depict a case of complicated pyogenic VO that required pharmacological and surgical intervention.