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Hypophosphatemia due to chronically increased renalphosphate clearance leads to variable bone diseasessuch as rickets and osteomalacia. The most commoninherited form of hypophosphatemia is X-linkedhypophosphatemic rickets. Other inherited forms ofthe disease are autosomal dominant and recessivehypophosphatemic rickets.This work should give a summary of the latestfindings in this hypophosphatemic disease anddiscusses reasons which lead to the illness. A lot ofpatients and also the two brothers who were discussedin this case report have clear hypophosphatemicsymptoms but no genetic reasons were found. Thisdisease gives also new cognitions about phosphatehomeostasis, althoug a lot of questions still remain.