The outcome of spinal tuberculosis diagnosed and treated in the early stages is good. When treated in the predestructive stage, the tubercular spinal lesions heal with no or little sequelae of kyphosis and neurological involvement. In advanced cases, due to continued destruction and attempted stabilization, significant deformities and neurological compromise can occur. Late correction of severe kyphotic deformities is technically demanding. Hence good clinical knowledge about the presentation of the disease, thorough clinical examination and effective use of investigations help in diagnosing the disease. The clinical assessment must allow the surgeon to arrive at a comprehensive diagnosis, which includes information about the location of the disease, pathological causation of the disease, pathological stage of the disease, neurological compromise, functional disturbances and an idea about what needs to be addressed in that particular patient. The clinical examination must be directed toward acquiring this information.