Bone Marrow Manifestations of Systemic Disease: When evaluating a bone marrow biopsy, our instinct is to focus on finding the malignancy; however, the bone marrow is also a window into the overall health of the patient. We will explore broad categories of systemic disorders manifesting in the bone marrow, including heritable bone marrow failure, storage and immunodeficiency disorders; infection-related marrow abnormalities; drug/toxin-related abnormalities; nutritional, metabolic and endocrine disorders; and rheumatologic/autoimmune disorders. Recognition of systemic disorders can guide clinical management, and avoid pitfalls of overdiagnosing malignancy.