This article presents expert consensus recommendations for diagnosing and treating chronic non-bacterial osteitis (CNO) in adults. A systematic review of existing literature and a multidisciplinary expert panel informed the creation of a standardized disease definition and proposed the term "CNO" to replace previous, less precise terminology. The recommendations cover diagnostic imaging, laboratory testing, and a tiered treatment approach starting with NSAIDs and moving to intravenous bisphosphonates or TNF-α inhibitors as needed. Long-term follow-up and a multidisciplinary care team are emphasized, along with a research agenda to improve understanding and treatment of this rare condition.