This book constitutes the proceedings of the 7th International Workshop and Challenge on Computational Methods and Clinical Applications for Spine Imaging, CSI 2019, which was held in conjunction with MICCAI on October 17, 2019, in Shenzhen, China. All submissions were accepted for publication; the book contains 5 peer-reviewed regular papers, covering topics of vertrebra detection, spine segmentation and image-based diagnosis, and 9 challenge papers, investigating (semi-)automatic spinal curvature estimation algorithms and providing a standard evaluation framework with a set of x-ray images.