A cold abscess is a localized collection of pus in a tissue, organ or confined space and lacks the usual hallmarks of acute inflammation. As the tuberculosis is a chronic low-grade infection, the abscesses thus generated do not possess the characteristic signs of acute inflammation and hence is named cold abscess. The incidence of cold abscess in spinal tuberculosis was described variably from 99 to 33% by different authors in literature. In the classic article Nichols’ states, “In a considerable proportion of the cases of tubercular disease of the spine no abscess is recognized during life, but in cases seen at autopsy, an abscess is almost invariably found, although it may be of small size. The size of cold abscess is not proportionate to the degree of destruction of the vertebral bodies.