Background: Spine pathologies have been increased in the past years worldwide being important cause of disability which represents significant economic losses. Objective: The objective of the study was to establish the incidence of spinal neurosurgical pathology in a national reference hospital in Mexico City (General Hospital of Mexico "Dr. Eduardo Liceaga"). Materials and methods: A descriptive, observational, retrospective, and cross-sectional study was carried out, using the database of all patients that were undergoing spinal surgery from January 2015 to January 2020. Measures of central tendency and percentages, demographic variables, diagnosis, and affected segment were assessed. Results: A total of 341 cases were analyzed, the group of patients with degenerative disease represents the main cause of care followed by neoplasms; trauma and special cases of congenital type and reoperations were the less frequent pathologies between the groups. In general, the most affected age group was 51-60 years. Conclusions: Within the study population, a wide range of diseases that affect the spine were treated, ranging from degenerative diseases, neoplasms, trauma, congenital, and infectious diseases.