Spinal infections can be divided into those affecting the bone (vertebral osteomyelitis), the disc space (discitis) and the intrathecal space. Occasionally, infectious processes can involve more than one or even all the three. Spinal infections are rare, although there is a recent resurgence with increasing spinal interventions and widespread use of chemotherapy for cancer, immunotherapy and HIV. High level of suspicion is required for prompt diagnosis. Nonsurgical antimicrobial treatment, following a CT guided biopsy and tissue culture is recommended. Neurological involvement invariably requires decompressive surgery without excision of lateral extension of the granulation tissue to avoid injury to radicular arteries; fusion with autogenous graft and posterior instrumentation may be done once the infection gets under control. Single stage decompression and instrumentation is avoided. Overall prognosis has improved with innovative spinal surgical techniques and instrumentations and wide range of antibiotics.