Since its identification in the 1950s as a systemic skeletal disorder, the etiology of Forestier’s disease or diffuse idiopathic skeletal hyperostosis (DISH) has remained unclear. Clinical studies have attempted to illuminate risk factors and associated pathological conditions without consensus. Prevalent in modern populations, DISH has been documented in multiple bioarchaeological populations as well as the fossil record (Rothschild 1987). Its antiquity has been established, yet the anthropological literature contains only one published case of DISH in a non-human primate, a 42 year old captive Pongo pygmaeus pygmaeus. Medical records from captivity, macroscopic diagnostic criteria, computed tomography (CT) and histological data are used here to differentially diagnose and document DISH in a captive female Gorilla gorilla gorilla as a proxy for an archaeological situation. Furthering our understanding and interpretation of the process this disease takes through three dimensional CT reconstruction and accompanying histological analysis of ectopic growth, this paper examines the use of conventional macroscopic identification of DISH and attempts to build bioarchaeological knowledge of diagnostic signatures of the disease. While investigating DISH in past populations, clinical studies must be referenced in order to interpret lifestyle risk factors in skeletal populations. Combining clinical data with human and captive non-human primate skeletal and lifestyle data will aide in further clarification of behavioral reconstructions of past populations. This paper will attempt to diagnose DISH in a gorilla through examination of multiple avenues of diagnostic criteria any of which may be available to the bioarchaeologist working with archaeological remains. Although DISH is a systemic condition characterized by disrupted bone metabolism resulting in abnormal growth, the focus of this research will remain on the vertebral column manifestations. Histological appearance of vertebral ectopic lesions will be documented. Increasing awareness of DISH in human and non-human primates will lead to a more accurate paleopathological differential diagnosis.