This chapter discusses evolution of treatment of skeletal tuberculosis. The evolution of treatment of tuberculosis of bones, joints, and spine has passed through different phases of development. The availability of antitubercular drugs, a significant milestone, divides the treatment of tuberculosis into two eras: preantitubercular era, and postantitubercular era. The most spectacular effect of the drugs was disappearance of sinuses, ulcers, and abscesses despite extensive surgery and the elimination of the danger of postoperative dissemination of tuberculous infection. Before the advent of antitubercular chemotherapy, sinus formation was regarded as one of the most dreaded complications of skeletal tuberculosis, and surgery of tuberculosis was usually complicated by the formation of sinuses.