We describe two cases of spontaneous sternal fracture with no underlying pathology other than a severe dorsal kyphosis resulting from osteoporosis. Both patients complained of chest pain. Sternal fractures are particularly likely to occur in the elderly when the costal cartilages become ossified and there is an associated thoracic kyphosis. In elderly patients with a kyphosis the lateral thoracic radiograph should include the sternum to ensure recognition of this complication.