Diffuse idiopathic skeletal hyperostosis (DISH) is a disorder showing hyperostosis of the spinal column and ossification of extraspinal ligaments or tendons. The prevalence of DISH has been found to be higher in historic peoples of the upper- and ruling classes, and in fact was closely correlative with nutritional and high-caloric diets. DISH is also known to be a function of genetic factors; as such, there have been very few cases of DISH found among the specimens of Asian skeletal collections. In our osteoarchaeological study on the Joseon Dynasty Human Sample Collection (JDHSC), we found four DISH instances among the 96 cases (4.17%) we examined. This prevalence is not so different from those discovered in already-published studies on collections in Europe and other regions. However, as already stated, it must be considered that most of the JDHSC individuals we examined were remains of people from the highest social classes of 16th–18th century Joseon society. Therefore, when collections from medieval European monastic sites, the appropriate control from well-fed populations, were used for comparison, the prevalence of DISH was found to be far lower among the JDHSC. Reports on DISH from examinations of collections in Asian countries have been spotty, leaving gaps in the social-strata spectrum. Further researches into the prevalence of DISH among the different social strata of ancient or medieval Asian peoples are still required. Copyright © 2010 John Wiley & Sons, Ltd.