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Thirty-one patients with 33 lesions of spinal tuberculosis (C1–D4) are reported. The distribution of lesions was C1–C2 (11), C3–C6 (13), C7–D4 (9). Neurological complications were present in 6 (55%), 8 (61%) and 7 (78%) in each region respectively. Increase in the prevertebral soft tissue shadow in a standard radiograph was a useful guide to resort to CT Scan/MRI to diagnose tuberculosis of C1 and C2 region at an early (pre-subluxation) stage. The diagnosis of TB spine from C3–C6 was made confidently on clinico-radiological features. The anterior convexity and forward displacement of tracheal shadow of more than 8 mm from the vertebral bodies in a lateral view of plain X-ray and widening of superior mediastinum in an AP X-ray are useful indicators of tuberculous involvement at cervicodorsal region (C7–D4). CT Scan/MRI should be done for early diagnosis in those cases with a high …