Langerhans cell histiocytosis (LCH) is a disease of unknown aetiology. It is characterised by extreme clinical heterogeneity that can bring it to the attention of a variety of healthcare workers. A high index of suspicion is key to early diagnosis. Once the diagnosis has been confirmed, all cases should be referred to a paediatric oncologist for risk stratification and further management. We present a case of a toddler with LCH with skeletal involvement, who primarily presented to an orthopaedic surgeon. Relevant knowledge about this condition is reviewed.