Infections of the spinal column is a very broad topic and includes those diseases that arise spontaneously and those that are secondary to some inciting event. True infections are uncommon, particularly in the industrialized countries of the world. The estimated annual frequency is 0.037 for disc space infection, 0.037 for bacterial vertebral osteomyelitis and 0.037 for epidural abscesses. Postoperative wound infections range from 1% after a simple discectomy to 6-8% after attempted fusion with hardware. Some patient groups are at risk. These are the smokers, the obese, the malnourished, the immunosuppressed (either due to acquired immunodeficiency syndrome AIDS or medical treatment for tumors, arthritis or organ transplantation), drug addicts, diabetics, or those who have undergone recent urinary tract instrumentation. The symptoms vary with the etiological factor but the back pain and low back pain without a history of trauma are the main symptoms in almost all patients. There is often a delay in the diagnosis because of the subtle presentation, the failure to appreciate unrelenting pain, and the absence of systemic signs such as temperature elevation. The laboratory findings are not specific and normal white blood cell counts are common. Direct radiographs often show no abnormalities early in the course of the illness, and even more sensitive diagnostic tests such as bone scintigraphy may not become positive for a week. When the diagnosis is uncertain, the magnetic resonance imaging seems to be the most reliable early confirmatory test, while elevations of the erythrocyte sedimentation rate are a valuable screening test.