Palaeopathology helps to define the migration of past diseases. Genetic and environmental factors play a role in the development of spondyloarthropathy (SpA). We report skeletal remains with SpA from the Jomon period in Japan. The skeleton is of a female who died at a young adult age. The skeleton had characteristic features seen in SpA as follows: (1) polyarticular arthritis; (2) erosions accompanying some bone formation; (3) enthesial ossification; and (4) periostitis in lower long bones. The findings suggest that SpA was present in prehistoric Japan before contact with European civilisation, and the present example of SpA is the oldest in Asia and the Old World. Copyright © 2004 John Wiley & Sons, Ltd.