Spinal osteoid osteoma and osteoblastoma are rare lesions that occur mainly in adolescents and young adults. Clinical findings and histological features are similar lesions. The main difference between osteoid osteoma and osteoblastoma lies in the potentially more aggressive biological behavior of osteoblastomas, causing neurological deficits to occur more frequently. These lesions should always be considered in the differential diagnosis of adolescents presenting with painful scoliosis. The primary treatment option for both diseases is surgical complete resection. With a successful surgery, very good results are obtained in pain control, and it is possible to regress the deformity in the appropriate patient group.