Pathologies involving the fusion of mosasaur vertebrae have been documented in the literature since the late 1870s. Although some instances can clearly be demonstrated to be the result of an attack by another predator, usually a shark, the source of the pathology is more difficult to discern in other specimens. Here we discuss the evidence for pathologies as the result of interactions with the mosasaur's habitat and the apparent susceptibility of certain kinds of disease affecting the skeleton as preserved in the specimens.