Aseptic osteitis pubis can be a possible cause of groin pain in young physically active patients. As a correlation with femoroacetabular impingement has been demonstrated, this pathological condition should also be considered as a possible cause. In older patients aseptic osteitis pubis is usually a degenerative alteration of the symphysis, which can also lead to groin pain. It is important to distinguish this from septic osteitis pubis, which is often associated with infections in the region of the true pelvis or previous surgery in this area. Vertebrogenic causes of groin pain are attributable to irritation of the nerve roots L1-L3, which can result from inflammatory, traumatic or degenerative alterations of the spine. This article provides an overview of these differential diagnoses based on case examples.