The clinical and radiographic features of 83 patients with a diagnosis of Ankylosing Spondylitis conforming to Rome criteria were reviewed. There was 64 males and 19 females attending for a mean duration of 13 and 11 years. Females presented with more peripheral arthritis (X2 = 3.15464, DF = 1, P < .05 (one sided) and more asymptomatic sacroiliitis (X2 = 6.70172; DF = 1, P < .01 (two sided)). Spinal involvement occurred with a similar frequency in men and women, no increase in cervical spine involvement in women was identified. Four males and one female of 83 patients, developed radiographically proven spinal fusion. One male patient developed upper lobe pulmonary fibrosis, one male patient developed the cauda equina syndrome, one male patient required a total hip replacement. No statistically significant difference in the rate of complications in men and women was identified.