This chapter discusses the problem of deformity in spinal tuberculosis. The advent of effective anti-tuberculous chemotherapy has made uncomplicated spinal tuberculosis a medical disease and the attention has turned to the problem of progressive deformity. Severe kyphosis is cosmetically and functionally disabling and can lead to late-onset paraplegia. It is imperative that prevention of deformity be an essential aspect of any treatment schedule in spinal tuberculosis. Tuberculosis preferentially affects the anterior structures of the vertebral column in more than 90% of patients. The severity of deformity depends on the extent of destruction, the age of the patient, and the level of lesion. Risk factors for severe increase in deformity, indications for surgery for prevention of deformity in spinal tuberculosis, surgery for prevention of deformity, and surgery for established deformity are also discussed in this chapter.