Congenital vertebral malformations (CVMs) and neural tube defects (NTDs) are common birth defects affecting the spine and nervous system due to early embryonic development issues. Our review delves into their shared embryonic origins, signaling pathways, and clinical characteristics, highlighting a significant overlap. The co-occurrence of CVMs and NTDs underscores the importance of comprehensive clinical assessments. However, the precise mechanisms connecting these conditions remain elusive. Our research underscores the urgency for further investigations to improve the diagnosis and treatment of individuals affected by these conditions. (By Dr Nan Wu, https://jmg.bmj.com/content/early/2023/09/28/jmg-2023-109501 )