Background: Extra pulmonary TB is an AIDS defining opportunistic infection in patients with HIV infection. TB spine is the commonest form of bone TB and whose clinical picture depends on the site and the presence of HIV infectionMethod: This was a retrospective review of patient records (n=101) over a two-year period (2008-2010) at the University Teaching Hospital, Lusaka, Zambia. Clinical and radiological features, laboratory data were analyzed Results: One hundred and one patients (57 male: 44 female) had TB spine in this period. The mean age was 37.22 ± 14.29 years. The main presenting complaint was backache in 71(70.3%) patients and the mean duration of symptoms was 2.68 ± 1.23 months. The Gibbus was present in 77 (76.24%) of the patients while neurological deficit was identified in 32 (31.6%) patients. The lumbar spine the most affected in 64(63.4%) patients. The mean ESR was determined to be 59.43 ± 32.23 mm/hour. The prevalence rate of HIV infection in the patients with TB spine was 24.8 %. The average CD4 count was found to be 262± 121.3 cells/μl.Conclusion: The prevalence rate of HIV infection (24.8%) is higher than that obtaining in the Zambian general population (13.7%) but lower than the general prevalence of HIV infection in patients with TB (68%).