Spinal tuberculosis remains common in the "Third World" and is commoner in Britain and "developed" countries than many other disorders that receive much more attention. Though little new has been added to knowledge of its morbid anatomy, the observation that it is associated with a low bacterial population is emphasised. Controlled clinical trials in Korea, Hong Kong and Bulawayo have demonstrated the excellent results of outpatient ambulant chemotherapy, which are unimproved by other additional measures with the one exception of the skilled performance of radical resection of the focus with anterior spinal fusion (the Kong Kong operation). The management of paraplegia is discussed, as are recent attempts to correct fixed residual kyphosis.