The disease of hypophosphatemic osteomalacia is clinically rare and easy to be misdiagnosed. It refers to a metabolic bone disease in which bone matrix can not be mineralized in the normal way due to hypophosphatemia. One case report of adult-onset sporadic hypophosphatemic osteomalacia ever misdiagnosed as spondyloarthropathy and related literature were studied. We should master the diagnosis and differential diagnosis of hypophosphatemic osteomalacia to improve the clinic diagnosis and treatment level.