Paget's disease of bone is the second most common metabolic bone disease. Despite this, information on bone microarchitecture, a crucial determinant of bone strength, is very limited. In particular, the microstructure of long, weight bearing bones never has been systematically assessed. In a collaboration between the Medical University of Vienna, the University of Vienna and the Museum of Natural History Vienna, Nebot et al. performed micro computed tomography analyses of historic femora and tibiae affected by Paget's disease. In the cortical compartments, increased cortical thickness, cortical porosity and trabecularisation of cortical structures was seen. In the trabecular compartments, severe defects, a disorganisation of trabecular structures and increased thickness of trabeculae were observed. These findings are relevant for the differential diagnosis and bone fragility in Paget's disease.