Small pox has been eradicated completely but its unique pathology and sequlae still come across in routine clinical practice. Osteoarticular changes following small pox infection has been elaborated in literature. We present a similar but rare patient with osteomyelitis variolosa and joint deformity involving elbow, wrist joints and humerus fracture. The condyles were typically elongated as central portion of distal humerus absorbed. Fracture united uneventfully following stabilization with dynamic compression plate and bone grafting. Patient showed satisfactory elbow function at the end of last follow-up.