Mayor Thomas M. Menino spent Thanksgiving in Brigham and Women's Hospital, visited by friends and family, a spokeswoman said.
The mayor shared the holiday with his wife Angela Menino, daughter Susan Menino Fenton, son Thomas Menino Jr., his six grandchildren, and two close personal friends, according to Dot Joyce, the mayor's spokeswoman.
Friday marks the start of Menino's fifth week in the hospital.
Menino has been in the hospital since Oct. 26, after returning early from a vacation in Italy. While initially hospitalized for an upper respiratory infection and a blood clot that traveled from his leg to his lungs, Menino was forced to extend his stay because of a compression fracture in his back.
Joyce said the mayor missed his usual Thanksgiving visits to organizations feeding those in need.
"He's disappointed that he's missing the holiday," Joyce said. "He does enjoy this day, going to all the stops he usually does and bringing attention to the issues of homelessness and hunger."
A traditional turkey dinner was on the menu, to be shared with hospital staff.
Joyce said Menino continues to improve and is now "much stronger than he was last week," but back pain continues to be an issue.
"It's certainly something they're trying to manage," Joyce said of the pain, "while he also does some rehab."
Health issues have dogged the 69-year-old mayor, and over the past two years he has been seen wearing a walking boot and using crutches.
Menino's representatives say that the mayor has continued his work from the hospital, making policy decisions and receiving updates on city issues through top aides, including Joyce, who visits him at the hospital regularly.
Other city officials, including Police Commissioner Edward F. Davis and Barbara Ferrer, executive director of the Boston Public Health Commission, told the Globe this week they had visited Menino to discuss city business in recent days.
While the mayor may carry on many tasks of governing during his convalescence, his absence is felt at public events.
Known for meeting constituents face to face at events around the city, Menino is especially active during the holiday season, attending more than a dozen annual tree lightings and other celebrations.
Menino's daughter has filled in for him at some recent events, including the distribution of coats to children at the Tobin Community Center in Roxbury on Nov. 10, and the kickoff for the city's annual Holidays on Main Streets campaign in the South End on Wednesday.
The mayor also missed events during the 2010 holiday season. That year, he was hospitalized after he contracted a skin infection during another trip to Italy. He later underwent surgery for a partially torn tendon in his right knee.
Spending more than a month out of the public eye — the mayor has not been in City Hall since departing for Italy — could have political consequences. Already Boston's longest-serving mayor, with more than 19 years in office, Menino is considering running next year for a sixth term. His hospitalization forced him to cancel a breakfast fund-raiser scheduled for Nov. 20.