Thank you for viewing. There is a slight crease at the bottom of the cover (see images 3-4). Other than that, there are no noticeable scratches or stains, and the pages inside are clean with no writing. Please check the condition in the images and understand that this is a used item before purchasing. "Rehabilitation for Hemiplegia I Trunk, Sitting, Standing, and Standing" Shozo Miyamoto Please consider it if you are interested.