Anterior approach in the surgical management of spinal tuberculosis gives satisfactory results as it provides direct access to the site of the disease process and ensures complete debridement of the lesion. Interbody fusion with grafts (autografts/allografts) after debridement provides structural support to the anterior column preventing the progression of kyphotic deformity. Additional stabilization of the spinal segment is necessary when more than two vertebral bodies are affected and the length of the graft is more than 4 to 5 cm to prevent graft-related complications. Anterior instrumentation with plates or rod-screw constructs provides better stability to the graft and prevents it from collapse or fracture. Combined anterior debridement and fusion followed by posterior stabilization in a single or two stages provides rigid fixation of the spinal column promoting early fusion and preventing kyphosis and graft related complications. Antitubercular chemotherapy is the main stay of treatment in the healing of the lesion and surgery is only an adjunct in the management of spinal TB.