The understanding of the thoracolumbar spine injuries has evolved over the last 75 years. The classification was initially based on the biomechanical basis of load bearing columns of the spinal column. This involved a combination of the morphology of the fracture as well as the mechanism of injury or the force leading to these fractures. The treatment recommendation, however, depends significantly on the injury severity and associated neurological damage. The most recent TLISS classification system incorporates these factors into the biomechanical basis of understanding of the thoracolumbar fractures. Currently, this classification system is undergoing studies looking into its clinical validity and interobserver reliability. The large numbers of classification systems being used concurrently in clinical practice are often confusing. Regardless of which classification is adopted in a clinical practice, it is important for the clinician to understand the rationale of the classification system, assessment of stability, indication for surgical stabilization and appropriate surgical approach.