Diffuse Idiopathic Skeletal Hyperostosis (DISH) is a systemic condition characterized by flowing ossification along the spine and peripheral entheses. Affecting up to one-third of older adults, DISH often presents with stiffness, reduced mobility, and in cervical cases, dysphagia or airway symptoms. Diagnosis relies on imaging demonstrating at least three contiguous vertebral bone bridges without sacroiliac inflammation. Although the exact cause remains unclear, metabolic, genetic, and mechanical factors are strongly implicated. Management focuses on pain control, mobility preservation, and targeted osteopathic treatment to address soft-tissue restriction, improve function, and support long-term quality of life.