We present a patient with osteomyelitis variolosa in both elbow joints with short middle fingers-sequelae of smallpox. Both elbow joints showed sclerosis of bones around elbow joint, enlargement of olecranon process of ulna, and head of radius with intact joint space. Hands showed shortening of both middle fingers following dactylitis leading to short metacarpals. The purpose of this report is to remind those who seldom see one of the most important and easily recognized complications of smallpox.